title: Activity and Safety of Sunitinib in Patients with Advanced Radioiodine Refractory Thyroid Carcinoma: A Retrospective Analysis of 57 Patients.
abstract: The aim of this study was to evaluate the effectiveness of sunitinib in patients with progressive radioiodine refractory (RAIR) thyroid cancer (TC).
  
  
  
  A multicentric retrospective analysis was performed of patients treated in six TUmeurs THYroïdiennes REFractaires participating centers. All patients with progressive RAIR TC who were treated with sunitinib outside a clinical trial between August 2007 and March 2015 were retrospectively and consecutively included. The primary endpoint was the overall response rate (ORR) and disease control rate ≥6 months based on RECIST criteria. Secondary endpoints included evaluation of overall survival (OS) and progression-free survival (PFS) from the first dose of sunitinib. Primary and secondary endpoints were also evaluated according to treatment setting: first or second line of tyrosine kinase inhibitor (TKI).
  
  
  
  Fifty-seven patients (29 men; 50.8%), mean age 62.2 years (range 43-80 years) with progressive RAIR TC were included. Sunitinib was the first-line TKI treatment for 32 (56.1%) patients and the second-line TKI treatment for 25 (43.9%) patients. For all patients, according to RECIST criteria, ORR was 35.1% (20 patients) and disease control rate ≥6 months was 68.4% (39 patients). No complete response was observed. Six (10.5%) patients showed disease progression. When sunitinib was used as first-line TKI therapy, ORR was 46.9% (15/32 patients), and disease control rate ≥6 months was 75% (24/32 patients). When sunitinib was used as second-line TKI therapy, ORR was 20% (5/25 patients), and disease control rate ≥6 months was 60% (15/25 patients). The median OS and PFS were 21.0 (range 15-29) and 10.2 months (range 6-13), respectively, for all patients. With sunitinib as first-line TKI-therapy, median OS and PFS was 30.0 (range 19.0-53.0) and 15 (range 7.0-21.0) months, respectively. As second-line therapy, median OS and PFS were 13 (range 8.0-20.0) and 6 (range 5.0-11.0) months, respectively. Eleven (19.3%) patients experienced grade 3 toxicity, and four patients (7.0%) experienced grade 4 toxicity.
  
  
  
  The efficacy of sunitinib as first- and second-line TKI therapy in a large cohort of patients treated for progressive RAIR TC is herein reported. Further prospective studies are needed to evaluate the effectiveness of sunitinib in RAIR TC.
authors.affiliation: 1 Department of Nuclear Medicine and Thyroid Oncology, Bergonie Institute , Bordeaux, France .
authors.forename: Vincent
authors.initials: V
authors.lastname: Atallah
authors.affiliation: 1 Department of Nuclear Medicine and Thyroid Oncology, Bergonie Institute , Bordeaux, France .
authors.forename: Arnaud
authors.initials: A
authors.lastname: Hocquelet
authors.affiliation: 2 Department of Endocrinology, University Hospital Lille , Lille, France .
authors.forename: Christine
authors.initials: C
authors.lastname: Do Cao
authors.affiliation: 3 Department of Nuclear Medicine, Cancer Institute , Toulouse, France .
authors.forename: Slimane
authors.initials: S
authors.lastname: Zerdoud
authors.affiliation: 4 Department of Oncology, Leon-Berard Center , Lyon, France .
authors.forename: Christelle
authors.initials: C
authors.lastname: De La Fouchardiere
authors.affiliation: 5 Department of Nuclear Medicine, François Baclesse Center , Caen, France .
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bardet
authors.affiliation: 1 Department of Nuclear Medicine and Thyroid Oncology, Bergonie Institute , Bordeaux, France .
authors.forename: Antoine
authors.initials: A
authors.lastname: Italiano
authors.affiliation: 6 Department of Nuclear Medicine and Endocrine Cancer, Gustave-Roussy Institute , Paris, France .
authors.forename: Anne
authors.initials: A
authors.lastname: Dierick-Galet
authors.affiliation: 1 Department of Nuclear Medicine and Thyroid Oncology, Bergonie Institute , Bordeaux, France .
authors.forename: Nicolas
authors.initials: N
authors.lastname: Leduc
authors.affiliation: 1 Department of Nuclear Medicine and Thyroid Oncology, Bergonie Institute , Bordeaux, France .
authors.forename: Françoise
authors.initials: F
authors.lastname: Bonichon
authors.affiliation: 6 Department of Nuclear Medicine and Endocrine Cancer, Gustave-Roussy Institute , Paris, France .
authors.forename: Sophie
authors.initials: S
authors.lastname: Leboulleux
authors.affiliation: 1 Department of Nuclear Medicine and Thyroid Oncology, Bergonie Institute , Bordeaux, France .
authors.forename: Yann
authors.initials: Y
authors.lastname: Godbert
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002291:Carcinoma, Papillary / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077210:Sunitinib; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib