2024 Volume 117 Issue 2 Pages 155-162
The prognosis of differentiated thyroid cancers is good, however, there are no established treatment options for patients with radioactive iodine-refractory and unresectable differentiated thyroid cancers. Lenvatinib was approved by the Japan Pharmaceuticals and Medical Devices Agency for the treatment of differentiated thyroid cancers in 2015. However, drug withdrawal or dose reduction is often necessary due to the emergence of adverse effects of these drugs. During the drug discontinuation period, disease progression was frequently observed, and the timing of TKI administration and the management of the adverse events have been discussed.
In this study, we analyzed the data of 12 patients of differentiated thyroid cancer who were treated with lenvatinib at our hospital between 2015 and 2020. Lenvatinib was started at the dose of 24 mg, and the dose was reduced as needed. The response rate was 75.0%, and the median progression free survival was 19.1 months. The results were compatible with those of the SELECT trial. Long-term administration of TKIs was possible with prophylactic treatment used for adverse events, adjustment of the administration schedule of lenvatinib, and timely switch to sorafenib.