Questions and Controversies in the Clinical Application of Tyrosine Kinase Inhibitors to Treat Patients with Radioiodine-Refractory Differentiated Thyroid Carcinoma: Expert Perspectives
Horm Metab Res 2021; 53: 149-160 DOI: 10.1055/a-1380-4154Notwithstanding regulatory approval of lenvatinib and sorafenib to treat
radioiodine-refractory differentiated thyroid carcinoma (RAI-R DTC),
important questions and controversies persist regarding this use of these
tyrosine kinase inhibitors (TKIs). RAI-R DTC experts from German tertiary
referral centers convened to identify and explore such issues; this paper
summarizes their discussions. One challenge is determining when to start TKI
therapy. Decision-making should be shared between patients and
multidisciplinary caregivers, and should consider tumor size/burden,
growth rate, and site(s), the key drivers of RAI-R DTC morbidity and
mortality, along with current and projected tumor-related symptomatology,
co-morbidities, and performance status. Another question involves choice of
first-line TKIs. Currently, lenvatinib is generally preferred, due to
greater increase in progression-free survival versus placebo treatment and
higher response rate in its pivotal trial versus that of sorafenib;
additionally, in those studies, lenvatinib but not sorafenib showed overall
survival benefit in subgroup analysis. Whether recommended maximum or lower
TKI starting doses better balance anti-tumor effects versus tolerability is
also u...
Source: Hormone and Metabolic Research - Category: Endocrinology Authors: Verburg, Frederik A. Amthauer, Holger Binse, Ina Brink, Ingo Buck, Andreas Darr, Andreas Dierks, Christine Koch, Christine K önig, Ute Kreissl, Michael C. Luster, Markus Reuter, Christoph Scheidhauer, Klemens Willenberg, Holger Sven Zielke, Andreas Schot Tags: Review Source Type: research
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