Thyroglobulin fluctuations in patients with iodine-refractory differentiated thyroid carcinoma on lenvatinib treatment - initial experience.
Tyrosine kinase inhibitors (TKI) have shown clinical effectiveness in iodine-refractory differentiated thyroid cancer (DTC). The corresponding role of serum thyroglobulin (Tg) in iodine-refractory DTC has not been investigated yet. 9 patients (3 female, 61 ± 8y) with progressive iodine-refractory DTC starting on lenvatinib were considered. Tumor restaging was performed every 2-3 months including contrast-enhanced computed tomography (CT, RECIST 1.1). Serum Tg was measured and compared to imaging findings. After treatment initiation, serum Tg levels dropped in all patients with a median reduction of 86.2%. During long-term follow-up (median, 25.2 months), fluctuations in Tg could be observed in 8/9 subjects. According to RECIST, 6/9 subjects achieved a partial response or stable disease with the remaining 3/9 experiencing progressive disease (2/3 with Tg levels rising above baseline). All of the patients with disease progression presented with a preceding continuous rise in serum Tg, whereas tumor marker oscillations in the subjects with controlled disease were only intermittent. Initiation of lenvatinib in iodine-refractory DTC patients is associated with a significant reduction in serum Tg levels as a marker of treatment response. In the course of treatment, transient Tg oscillations are a frequent phenomenon that may not necessarily reflect morphologic tumor progression.
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
R A
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Werner
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
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Lückerath
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
J S
JS
Schmid
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
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T
Higuchi
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.|Department of Nuclear Medicine, Hospital Augsburg, Augsburg, Germany.
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MC
Kreissl
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
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I
Grelle
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
C
C
Reiners
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
A K
AK
Buck
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
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Lapa
D018263:Adenocarcinoma, Follicular / Q000097:blood* / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D002291:Carcinoma, Papillary / Q000097:blood* / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D002454:Cell Differentiation; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011804:Quinolines / Q000627:therapeutic use*; D011836:Radiation Tolerance / Q000187:drug effects*; D013954:Thyroglobulin / Q000097:blood*; D013964:Thyroid Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D007457:Iodine Radioisotopes; D010671:Phenylurea Compounds; D011804:Quinolines; D013954:Thyroglobulin; C531958:lenvatinib