A proposed clinical scoring system for initiation of lenvatinib treatment in radioiodine-refractory thyroid cancer patients

Purpose The optimal timing for starting lenvatinib treatment in patients with radioiodine-refractory differentiated thyroid cancer (RR-DTC) has long been controversial because of the relatively slow-growing nature of differentiated thyroid cancer. The aim of this study was to establish a scoring sys...

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Bibliographic Details
Published in:Endocrine 2022-04, Vol.76 (1), p.70-77
Main Authors: Fukuda, Naoki, Toda, Kazuhisa, Udagawa, Shohei, Ohmoto, Akihiro, Oki, Ryosuke, Suto, Hirotaka, Wang, Xiaofei, Hayashi, Naomi, Urasaki, Tetsuya, Sato, Yasuyoshi, Nakano, Kenji, Ono, Makiko, Tomomatsu, Junichi, Mitani, Hiroki, Takahashi, Shunji
Format: Article
Language:English
Subjects:
Adenocarcinoma - drug therapy
Algorithms
Antineoplastic Agents - therapeutic use
Clinical outcomes
Decision making
Diabetes
Endocrinology
Humanities and Social Sciences
Humans
Internal Medicine
Iodine Radioisotopes - therapeutic use
Leukocytes (neutrophilic)
Lymphocytes
Medical prognosis
Medicine
Medicine & Public Health
Metastases
multidisciplinary
Original Article
Patients
Phenylurea Compounds - therapeutic use
Protein Kinase Inhibitors - therapeutic use
Quinolines - therapeutic use
Retrospective Studies
Risk groups
Science
Thyroid cancer
Thyroid Neoplasms - drug therapy
Thyroid Neoplasms - radiotherapy
Tumors
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Summary:Purpose The optimal timing for starting lenvatinib treatment in patients with radioiodine-refractory differentiated thyroid cancer (RR-DTC) has long been controversial because of the relatively slow-growing nature of differentiated thyroid cancer. The aim of this study was to establish a scoring system using known clinical factors to simplify decision-making in when to start lenvatinib in RR-DTC patients. Methods We retrospectively analyzed RR-DTC patients treated with lenvatinib. We developed the clinical indication scoring algorithm on the basis of age, tumor-related symptoms, histology, metastatic sites, neutrophil-to-lymphocyte ratio, size of lung metastases, baseline sum of tumor diameters, and tumor-volume doubling time that was used to categorize patients into low-, intermediate-, and high-risk groups. Results A total of 59 patients were analyzed; 13 low-risk, 36 intermediate-risk, and 10 high-risk. The respective median progression-free survival from the initiation of lenvatinib was 93.7 months in the low-risk group, 20.3 months in the intermediate-risk group, and 6.2 months in the high-risk group ( p  
ISSN:1559-0100
1355-008X
1559-0100
DOI:10.1007/s12020-021-02963-z