Pre-therapeutic evaluation and practical management of cardiovascular and renal toxicities in patients with metastatic radioiodine-refractory thyroid cancer treated with lenvatinib

Wassermann, Johanna; Bagnis, Corinne Isnard; Leenhardt, Laurence; Éderhy, Stéphane; Buffet, C

doi:10.1080/14740338.2022.2153115

Cited by 3 publications

(4 citation statements)

References 36 publications

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“…However, thyroid cancer surgery following lenvatinib therapy is limited 15 . In this study, we identified ischaemic changes in PTC and FTC specimens probably due to inhibition of angiogenesis, a key effect of lenvatinib 7 . Coagulative necrosis was observed around the central lesions in cases 1, 2 and 4.…”

Section: Discussionmentioning

confidence: 78%

“…15 In this study, we identified ischaemic changes in PTC and FTC specimens probably due to inhibition of angiogenesis, a key effect of lenvatinib. 7 Coagulative necrosis was observed around the central lesions in cases 1, 2 and 4. This confirms progressive ischaemia and coagulative necrosis pattern as the final stage of ischaemia.…”

Section: Discussionmentioning

confidence: 93%

“…The proportion of residual cancer cells was estimated through histological assessment of the lesions. We examined lenvatinib's angiogenesis inhibition 7 referring to ischaemic colitis patterns. Coagulative necrosis and ischaemic changes in cancer cells were semiquantitatively assessed 8 .…”

Section: Methodsmentioning

confidence: 99%

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Histological findings of thyroid cancer after lenvatinib therapy

Okubo,

Toda,

Sato

et al. 2023

Histopathology

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AimsLenvatinib is a multikinase inhibitor used for treating unresectable or metastatic cancers, including thyroid cancer. As total thyroidectomy followed by radioactive iodine therapy is a commonly recommended initial treatment for thyroid cancer, histological findings of the thyroid after lenvatinib therapy remain unclear. Therefore, the aim of this study was to analyse in‐vivo changes in patients who underwent thyroidectomy after lenvatinib therapy.Methods and resultsWe screened 167 patients with thyroid cancer [papillary thyroid cancer (PTC), n = 102; follicular thyroid cancer (FTC), n = 26; anaplastic thyroid cancer (ATC), n = 39] who underwent lenvatinib therapy. Among these patients, six underwent thyroidectomy (lenvatinib‐treated group: PTC, n = 3; FTC, n = 1; ATC, n = 2), and the specimens were examined. Five patients with PTC who did not receive lenvatinib therapy were included for comparison (untreated group). Microvessel density (MVD) was evaluated in both groups. The PTC and FTC specimens showed relatively more ischaemic changes than ATC specimens. Coagulative necrosis and ischaemic changes in cancer cells were frequently observed. ATC specimens showed fibrosis and mild cell damage. As hypothyroidism is a common side effect of lenvatinib therapy, non‐cancerous thyroid tissues were also examined. Histological findings included mild lymphocytic infiltration, lymphoid follicular formation, histiocytic reaction and follicular epithelial destruction. The MVD in lenvatinib‐treated tissues was significantly lower than that in untreated tissues.ConclusionsLenvatinib therapy probably induces relatively specific ischaemic changes in thyroid cancer cells. Moreover, inflammatory cell infiltration and decreased MVD occur to varying degrees in non‐cancerous thyroid tissue and may be related to hypothyroidism, a side effect of lenvatinib.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 93%

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Histological findings of thyroid cancer after lenvatinib therapy

Okubo,

Toda,

Sato

et al. 2023

Histopathology

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“…Herein, the question of LVN resistance has naturally become a hot topic for scientists to study, no matter in the cancer types of RCC, HCC or DTC ( Hu et al, 2022a ; Persano et al, 2022 ). At present, LVN has achieved good efficacy in the targeted therapy of many cancer types ( Su et al, 2022a ; Wassermann et al, 2022 ). However, in cancer types such as liver cancer, once LVN is resistant to drugs, the drug effect of second-line therapy is often poor ( Jindal et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%