Response to sorafenib treatment in advanced metastatic thyroid cancer

Abstract

Objective: To investigate the efficacy of sorafenib in progressive radioiodine resistant metastatic thyroid carcinoma. Subjects and methods: Off-label observational study. Sorafenib 400 mg twice daily was evaluated. Therapy duration was 12 ± 3 months (range 6-16 months). Results: Eight patients were included (seven papillary, one insular variant). The eight patients meeting study criteria received sorafenib 400 mg orally twice a day until disease progression or unacceptable toxicity developed. One patient showed a partial response with tumor regression of -35%, six months after the beginning of the treatment; five patients exhibited stable disease and two patients had progressive disease and died. Thyroglobulin decreased within 4 weeks in all patients by 50% ± 23%. Adverse events: one patient had heart failure, and recovered after sorafenib withdrawal. However, she died five months later of sudden death. Conclusion: These data suggest a possible role for sorafenib in the treatment of progressive metastatic DTC. Adverse event are usually manageable, but severe ones may appear and these patients should be strictly controlled. Arq Bras Endocrinol Metab. 2014;58(1):37-41 Keywords Metastasis; sorafenib; thyroid; cancer RESUMO Objetivo: Investigar a eficácia do sorafenibe no carcinoma de tireoide metastático progressivo e refratário à iodoterapia. Sujeitos e métodos: Estudo observacional do efeito do sorafenibe off-label administrado 400 mg duas vezes ao dia. A duração da terapia foi de 12 ± 3 meses (variação de 6-16 meses). Resultados: Oito pacientes foram incluídos (sete com variante papilífera e um com variante insular). Os oito pacientes que preencheram os critérios do estudo receberam o sorafenibe 400 mg por via oral duas vezes por dia até progressão da doença ou toxicidade inaceitável. Um paciente apresentou uma resposta parcial com regressão tumoral da lesão alvo de 35% seis meses após o início do tratamento; cinco pacientes apresentaram doença estável e dois pacientes progrediram e morreram. A tireoglobulina diminuiu 50% ± 23% em 4 semanas em todos os pacientes. Eventos adversos: um paciente teve insuficiência cardíaca e morreu por morte súbita cinco meses após a retirada do sorafenibe. Conclusão: Esses dados sugerem um possível papel para sorafenibe para o tratamento do CDT metastático progressivo. Arq Bras Endocrinol Metab. 2014;58(1):37-41Descritores

New Therapies for Dedifferentiated Papillary Thyroid Cancer

“…Also, other more recently published studies suggest a possible role for sorafenib in the treatment of progressive metastatic DTC [ 65 , 66 ].…”

Treatment of advanced thyroid cancer with targeted therapies: ten years of experience

“…For this reason, and based on the evidence of its clinical benefits obtained in previous phase 2 studies (Gupta-Abramson et al 2008, Kloos et al 2009), sorafenib can be used 'off label' in many countries, and several studies confirming the efficacy of the drug in treating RAI-R DTC have been already reported (Marotta et al 2013, Pitoia 2014.…”

Selective use of sorafenib in the treatment of thyroid cancer

“…More recently, additional published studies have shown similar response rates as previously reported. 71 , 72 In Argentina, Pitoia 73 published his clinical experience in eight patients with DTC who received off-label sorafenib. One patient exhibited a maintained PR for 16 months, five patients had a SD for 8±3 months, and two patients showed SD for 8 months and 12 months, respectively, and then have a PD at final follow-up.…”

“…One patient exhibited a maintained PR for 16 months, five patients had a SD for 8±3 months, and two patients showed SD for 8 months and 12 months, respectively, and then have a PD at final follow-up. 73 …”