Rechallenge with Lenvatinib after Refractoriness to Initial Lenvatinib Followed by Sorafenib in a Patient with Metastatic Papillary Thyroid Carcinoma

Takinami, Masaki; Yokota, Tomoya

doi:10.1159/000507344

Cited by 11 publications

(11 citation statements)

References 15 publications

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“…35 This is underscored by the different toxicity profiles 5 and by the non-overlapping clinical activity, as also shown in thyroid cancer. 36 The LEP index has some relevant advantages: it is easily calculated, it is based on variables (albumin, bilirubin, lymphocytes, BCLC stage, previous TACE yes/no) that are commonly assessed in patients with HCC (thus not requiring additional examinations) and clearly identifies three groups with sharp differences in patients treated with lenvatinib, with a considerable sample size (n ¼ 404). Furthermore, and potentially more important, the comprehensive nature of the LEP index should be underscored.…”

Section: Discussionmentioning

confidence: 99%

Identification of lenvatinib prognostic index via recursive partitioning analysis in advanced hepatocellular carcinoma

et al. 2021

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Background: After the advent of new treatment options for advanced hepatocellular carcinoma (HCC), the identification of prognostic factors is crucial for the selection of the most appropriate therapy for each patient. Patients and methods: With the aim to fill this gap, we applied recursive partitioning analysis (RPA) to a cohort of 404 patients treated with lenvatinib. Results: The application of RPA resulted in a classification based on five variables that originated a new prognostic score, the lenvatinib prognostic index (LEP) index, identifying three groups: low risk [patients with prognostic nutritional index (PNI) >43.3 and previous trans-arterial chemoembolization (TACE)]; medium risk [patients with PNI >43.3 but without previous TACE and patients with PNI <43.3, albumin-bilirubin (ALBI) grade 1 and Barcelona Clinic Liver Cancer stage B (BCLC-B)]; high risk [patients with PNI <43.3 and ALBI grade 2 and patients with PNI <43.3, albumin-bilirubin (ALBI) grade 1 and Barcelona Clinic Liver Cancer stage C (BCLC-C)]. Median overall survival was 29.8 months [95% confidence interval (CI) 22.8-29.8 months] in low risk patients (n ¼ 128), 17.0 months (95% CI 15.0-24.0 months) in medium risk (n ¼ 162) and 8.9 months (95% CI 8.0-10.7 months) in high risk (n ¼ 114); low risk hazard ratio (HR) 1 (reference group), medium risk HR 1.95 (95% CI 1.38-2.74), high risk HR 4.84 (95% CI 3.16-7.43); P < 0.0001. The LEP index was validated in a cohort of 127 Italian patients treated with lenvatinib. While the same classification did not show a prognostic value in a cohort of 311 patients treated with sorafenib, we also show a possible predictive role in favor of lenvatinib in the low risk group. Conclusions: LEP index is a promising, easy-to-use tool that may be used to stratify patients undergoing systemic treatment of advanced HCC.

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Section: Discussionmentioning

confidence: 99%

Identification of lenvatinib prognostic index via recursive partitioning analysis in advanced hepatocellular carcinoma

et al. 2021

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“…Tumor re‐sensitization after lenvatinib rechallenge was reported in patients with advanced thyroid carcinoma and hepatocellular carcinoma (HCC) 9–11 . Two cases of thyroid carcinoma and five of HCC were previously reported (Table 1).…”

Section: Discussionmentioning

confidence: 98%

Lenvatinib rechallenge in a patient with advanced thymic carcinoma: A case report

et al. 2022

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Advanced thymic carcinomas have limited treatment options. Recently, lenvatinib was approved for advanced thymic carcinoma treatment. However, the clinical benefit of lenvatinib re-administration in patients with advanced thymic carcinoma who developed prior lenvatinib treatment resistance (lenvatinib rechallenge) remains unclear. Here, we present a case treated with lenvatinib rechallenge for advanced thymic carcinoma who was previously treated with lenvatinib as the second-line treatment followed by multiple cytotoxic agents. Disease control rapidly deteriorated after the eighth line of treatment because of uncontrollable right pleural and pericardial effusion, which required repeated thoracic and pericardial drainage. Shortly after lenvatinib re-administration, rapid pleural and pericardial effusion reduction was observed. Thereafter, the patient achieved sustained clinical response with good pleural and pericardial effusion control for approximately 7 months. Our case might suggest lenvatinib rechallenge as a treatment option for patients with advanced thymic carcinoma, especially those with poor pleural and pericardial effusion control.

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“…Lenvatinib, a US Food and Drug Administration approved oral drug, is widely used to treat adult well-differentiated thyroid cancer. In addition to its definite efficacy in treating adult patients with drug resistance, recurrence, metastasis, and rare pathological subtype ( Tori and Shimo, 2018 ; Ito et al, 2019a ; Takinami and Yokota, 2020 ), lenvatinib shows potential for application in the treatment of children with PTC who are intractable or not tolerant to conventional therapy ( Mahajan et al, 2018 ). Furthermore, it brings new hope to patients with advanced unresectable PTC, for whom this novel option may increase the opportunity for surgical resection ( Iwasaki et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

PSG7 indicates that age at diagnosis is associated with papillary thyroid carcinoma: A study based on the cancer genome atlas data

2022

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The age of the patients at diagnosis (age at diagnosis) is a self-contained element of danger for the prognosis of patients with papillary thyroid carcinoma (PTC), which has been well recognized and continuously adopted by the international cancer staging system. However, few studies have investigated its intrinsic mechanisms. In this study, we aim to comprehensively reveal the age-related pathogenesis of PTC and identify potential prognostic biomarkers. We divided the samples into two groups, young and elderly, to filter differentially expressed genes in The Cancer Genome Atlas (TCGA), with an age of 55 years serving as a cutoff. Moreover, we combined univariate, LASSO, and multivariate Cox regression analyses to construct age-related signatures for predicting progression-free survival. Additionally, functional enrichment analysis, immune infiltration analysis, differential expression analysis, clinicopathological correlation analysis, and drug sensitivity analysis were performed in different risk subgroups and expression subgroups. We screened 88 upregulated genes and 58 downregulated genes. Both the LASSO regression model that is validated in TCGA and the model of six age-related prognostic genes (IGF2BP1, GPRC6A, IL37, CRCT1, SEMG1, and PSG7) can be used to evaluate the progression-free survival of PTC patients. The GO, KEGG, and GSEA analyses revealed that each key gene was closely associated with PTC development. Furthermore, CD8+ T cells decreased significantly, while regulatory T cells increased dramatically in the high-risk and PSG7 high expression groups. PSG7 was remarkably correlated with clinicopathological parameters (pathologic stage, T stage, and N stage) of PTC patients, and PSG7 expression was elevated in tumor samples from both TCGA and the Gene Expression Omnibus and was strongly associated with progressive stage and poor prognosis. Our results provide an innovative understanding of the age-related molecular mechanisms of PTC development. PSG7 was identified to exert a critical role in PTC progression and may serve as a promising strategy for predicting the prognosis of PTC.

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Rechallenge with Lenvatinib after Refractoriness to Initial Lenvatinib Followed by Sorafenib in a Patient with Metastatic Papillary Thyroid Carcinoma

Cited by 11 publications

References 15 publications

Identification of lenvatinib prognostic index via recursive partitioning analysis in advanced hepatocellular carcinoma

Identification of lenvatinib prognostic index via recursive partitioning analysis in advanced hepatocellular carcinoma

Lenvatinib rechallenge in a patient with advanced thymic carcinoma: A case report

PSG7 indicates that age at diagnosis is associated with papillary thyroid carcinoma: A study based on the cancer genome atlas data

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