title: Sorafenib in metastatic thyroid cancer.
abstract: Although thyroid cancer usually has an excellent prognosis, few therapeutic options are available in the refractory setting. Based on the recent results of phase II studies with tyrosine kinase inhibitors, we designed a retrospective analysis of patients with metastatic thyroid cancer treated with sorafenib in seven Spanish referral centers. Consecutive patients with progressive metastatic thyroid cancer (papillary, follicular, medullary, and anaplastic) not suitable for curative surgery, radioactive-iodine therapy, or radiotherapy were treated with sorafenib 400 mg twice a day. The primary end point was objective response rate (RR). Secondary end points included toxicity, median progression-free survival (mPFS), median overall survival (mOS), and correlation between tumor marker levels (thyroglobulin, calcitonin, and carcinoembryonic antigen) and efficacy. Between June 2006 and January 2010, 34 patients were included in the study. Sixteen patients presented differentiated thyroid carcinomas (DTC) of which seven (21%) were papillary, nine (26%) follicular, 15 (44%) medullary (MTC), and three (9%) were anaplastic (ATC). Eleven (32%) patients achieved partial response and 14 (41%) had stable disease beyond 6 months. Regarding histological subtype, RRs were 47% (seven of 15) for MTC, 19% (three of 16) for DTC, and 33% (one of three) for ATC. With a median follow-up of 11.5 months, mPFS were 13.5, 10.5, and 4.4 months for DTC, MTC, and ATC respectively. Tumor markers were evaluated in 22 patients, and a statistically significant association was observed between RR and decrease in tumor marker levels >50% (P=0.033). In this retrospective trial, sorafenib showed antitumor efficacy in all histological subtypes of thyroid cancer, warranting further development in this setting.
authors.affiliation: Medical Oncology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain. jacapdevila@vhebron.net
authors.forename: Jaume
authors.initials: J
authors.lastname: Capdevila
authors.forename: Lara
authors.initials: L
authors.lastname: Iglesias
authors.forename: Irene
authors.initials: I
authors.lastname: Halperin
authors.forename: Angel
authors.initials: A
authors.lastname: Segura
authors.forename: Javier
authors.initials: J
authors.lastname: Martínez-Trufero
authors.forename: Maria Ángeles
authors.initials: MÁ
authors.lastname: Vaz
authors.forename: Jesús
authors.initials: J
authors.lastname: Corral
authors.forename: Gabriel
authors.initials: G
authors.lastname: Obiols
authors.forename: Enrique
authors.initials: E
authors.lastname: Grande
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Grau
authors.forename: Josep
authors.initials: J
authors.lastname: Tabernero
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000627:therapeutic use*; D002116:Calcitonin / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D009362:Neoplasm Metastasis; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077157:Sorafenib; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D002272:Carcinoembryonic Antigen; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D002116:Calcitonin; D013954:Thyroglobulin; D000077157:Sorafenib