Objective: Sorafenib significantly prolonged progression-free survival in patients with iodinerefractory advanced thyroid cancer. The present study was initiated before sorafenib was approved in Colombia and therefore represents an effort by an oncology institution to evaluate its efficacy and safety in this population. Subjects and methods: This phase II clinical trial had a single treatment arm. We included adult patients with progressive metastatic iodine-refractory thyroid cancer who received treatment with sorafenib 800 mg/day (400 mg every 12 hours) up to a maximum of 24 months or until the occurrence of limiting related toxicity, the progression of the disease, or voluntary withdrawal. Results: Nineteen patients received the treatment and were included in the safety analysis. However, for the efficacy analysis, 6 patients were excluded because they received only one month of therapy. Thirteen (68%) patients were women, and the mean age at diagnosis was 61.8 years. No complete responses were observed; 5 patients had a partial response (35.7%), 6 patients had stable disease, and 3 showed progression. Mean progression-free survival was calculated at 18 months (95% CI 10.7-20.3). Overall survival was estimated at 21.3 months (95% CI 17.8-24.8). Conclusion: For the first time in Colombia, the efficacy of sorafenib was evaluated in patients with advanced and progressive thyroid carcinoma refractory to radioactive iodine, with an efficacy and a safety profile similar to those previously reported.
El carcinoma adrenocortical es una neoplasia endocrina infrecuente pero con un comportamiento altamente agresivo y pobre pronóstico. Dado su baja prevalencia, la experiencia de los centros de referencia es fundamental para caracterizar los factores asociados a esta entidad.
Métodos: Se elaboró una serie de casos de pacientes con diagnóstico confirmado de carcinoma adrenal, tratados en una institución oncológica de referencia entre enero de 2007 y diciembre de 2017. Se describieron las características clínicas e histopatológicas de los pacientes. Se estimó el tiempo de supervivencia libre de progresión y tiempo de supervivencia global (SG) de forma gráfica y con funciones de tiempo al evento mediante la función de Kaplan-Meier
Resultados: Se identificaron 19 pacientes, 14 de los cuales fueron mujeres con edad media del diagnóstico de 43.4 años (rango 20 – 65). El 58% de los pacientes tuvo secreción hormonal, siendo el síndrome de Cushing el predominante. 7 pacientes tuvieron compromiso metástasico al momento del diagnóstico. Todos los pacientes fueron llevados a adrenalectomía, el estado postquirúrgico en 10 pacientes fue R0. 11 pacientes estaban vivos al momento de finalización del estudio. La mediana promedio de supervivencia libre de progresión fue de 18 meses +/- 7.86 y la mediana de supervivencia global fue de 30 meses +/-19.80. Se encontró asociación del Ki 67 con mortalidad y progresión (p=0.01)
Conclusión: Las características clínicas e histológicas en nuestros pacientes son similares a los estudios de cohorte publicados. El Ki67 >10 fue un factor asociado a progresión y mortalidad.
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