Feasibility of Apatinib in Radioiodine-Refractory Differentiated Thyroid Carcinoma

Abstract

ObjectivesOur aim was to describe our experience in using apatinib as treatment for radioiodine-refractory differentiated thyroid carcinoma (RAIR-DTC).MethodsForty-seven patients undergoing apatinib treatment for RAIR-DTC were prospectively enrolled in this study. The study endpoints were objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and rate of adverse events.ResultsNo patients achieved complete response, while 36 (76.6%) and 8 (17.0%) patients achieved partial response and stable disease, respectively. The ORR and DCR were 76.6% and 93.6%, respectively. The median PFS and OS were 18 and 59 months, respectively. A total of 91 adverse events occurred, of which 21 were graded as grade 3 or higher. There were no drug-related deaths.ConclusionsApatinib has distinct anti-RAIR-DTC efficacy in terms of ORR, PFS, and OS and has a favorable safety profile. It is a feasible treatment option for RAIR-DTC.

Apatinib weakens proliferation, migration, invasion, and angiogenesis of thyroid cancer cells through downregulating pyruvate kinase M2

“…Lin et al 49 have reported in their phase II clinical trial that Apatinib has shown therapeutic efficacy in radioiodine-refractory differentiated thyroid cancer (RAIR-DTC), achieving an objective response rate (ORR) of 80% and a disease control rate (DCR) of 95%. The study by Du et al 50 has also found that the patients undergoing Apatinib for RAIR-DTC, have achieved an ORR of 80% and a DCR of 90%. Zhang et al 14 have reported a case of an inoperable locally advanced DTC patient, who has undergone a curative operation after the treatment of preoperative monotherapy of apatinib.…”

Leveraging molecular targeted drugs and immune checkpoint inhibitors treat advanced thyroid carcinoma to achieve thyroid carcinoma redifferentiation

“…Apatinib, developed in China, extended the median PFS in RAI-RDTC patients by 12.6 months compared with the sorafenib study (DECISION trial). The IC 50 (1 nM) of apatinib's VEGFR-2 in vitro was significantly lower than the IC 50 values of sorafenib and lenvatinib [78], resulting in higher selective VEGFR-2 inhibition and stronger redifferentiation. Moreover, apart from apatinib, other drugs have also been utilized in patients with RAI-RDTC to achieve redifferentiation and improve outcomes.…”

Efficacy and safety of tyrosine kinase inhibitors for advanced metastatic thyroid cancer: A systematic review and network meta-analysis of randomized controlled trials

“…Through our indirect comparison, in terms of OS, the indirect comparison of 6 drugs and placebo showed apatinib had a relatively better OS improvement effect than other drugs, perhaps because apatinib is a novel vascular endothelial cell growth factor receptor inhibitor made in China, [ 27 ] which can effectively inhibit the kinase activity of vascular endothelial growth factor receptor2 (VEGFR-2), KIT proto-oncogene receptor tyrosine kinase (KIT), and sarcoma gene (SRC) and inhibit the phosphorylation of VEGFR-2, KIT and platelet growth factor receptor b (PDGFRb). [ 28 ] In previous studies, apatinib was shown to have an effect on human patients who had received chemotherapy for thyroid cancer and other advanced cancers, such as gastric cancer (6.5 vs 4.7 months, P = .0149), liver cancer, colorectal cancer, and breast cancer.…”

“…Previous clinical studies have shown that apatinib is a viable treatment option for advanced thyroid cancer with significant efficacy in ORR, PFS, and OS, and a good safety profile. [ 27 ] Secondly, lenvatinib had a certain improvement effect on OS, while the other 5 drugs did not show a good improvement effect.…”