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Role of Salvage Targeted Therapy in Differentiated Thyroid Cancer Patients Who Failed First-Line Sorafenib

Context: Sorafenib, a tyrosine kinase inhibitor, is a common first-line therapy for advanced differentiated thyroid cancer (DTC). However, responses are not durable and drug toxicity remains a problem. Objective: The objective of the study was to determine the efficacy of salvage therapy after first... Full description

Journal Title: The journal of clinical endocrinology and metabolism 2014-06, Vol.99 (6), p.2086-2094
Main Author: Dadu, Ramona
Other Authors: Devine, Catherine , Hernandez, Mike , Waguespack, Steven G , Busaidy, Naifa L , Hu, Mimi I , Jimenez, Camilo , Habra, Mouhammad A , Sellin, Rena V , Ying, Anita K , Cote, Gilbert J , Sherman, Steven I , Cabanillas, Maria E
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: Endocrine Society
ID: ISSN: 0021-972X
Link: https://www.ncbi.nlm.nih.gov/pubmed/24628550
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4037722
title: Role of Salvage Targeted Therapy in Differentiated Thyroid Cancer Patients Who Failed First-Line Sorafenib
format: Article
creator:
  • Dadu, Ramona
  • Devine, Catherine
  • Hernandez, Mike
  • Waguespack, Steven G
  • Busaidy, Naifa L
  • Hu, Mimi I
  • Jimenez, Camilo
  • Habra, Mouhammad A
  • Sellin, Rena V
  • Ying, Anita K
  • Cote, Gilbert J
  • Sherman, Steven I
  • Cabanillas, Maria E
subjects:
  • Abridged Index Medicus
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols - therapeutic use
  • Carcinoma, Papillary, Follicular - drug therapy
  • Carcinoma, Papillary, Follicular - mortality
  • Carcinoma, Papillary, Follicular - pathology
  • Chemotherapy, Adjuvant
  • Drug Resistance, Neoplasm - drug effects
  • Endocrine Care
  • Female
  • Humans
  • Male
  • Middle Aged
  • Molecular Targeted Therapy
  • Neoadjuvant Therapy
  • Neoplasm Metastasis
  • Niacinamide - analogs & derivatives
  • Niacinamide - therapeutic use
  • Phenylurea Compounds - therapeutic use
  • Protein Kinase Inhibitors - therapeutic use
  • Retrospective Studies
  • Salvage Therapy - methods
  • Thyroid Neoplasms - drug therapy
  • Thyroid Neoplasms - mortality
  • Thyroid Neoplasms - pathology
  • Treatment Failure
ispartof: The journal of clinical endocrinology and metabolism, 2014-06, Vol.99 (6), p.2086-2094
description: Context: Sorafenib, a tyrosine kinase inhibitor, is a common first-line therapy for advanced differentiated thyroid cancer (DTC). However, responses are not durable and drug toxicity remains a problem. Objective: The objective of the study was to determine the efficacy of salvage therapy after first-line sorafenib failure. Design: This was a retrospective review at M. D. Anderson Cancer Center from January 2005 to May 2013. Patients: The study included patients with metastatic DTC who received salvage therapy after their initial sorafenib failure (group 2). Patients who received first-line sorafenib only (group 1) were evaluated for comparison of overall survival (OS). Outcome Measures: Progression-free survival, best response, and median OS were measured. Results: Sixty-four patients with metastatic, radioactive iodine refractory DTC were included; 35 were in group 1 and 25 were in group 2, and the groups were well balanced. Median OS of all 64 patients receiving first line sorafenib was 37 months; median OS was significantly longer with salvage therapy compared with sorafenib alone (58 vs 28 months, P = .013). In group 2, 17 patients were evaluable for best response, although two patients had toxicity with sorafenib, which was discontinued before restaging. Best responses with first-line sorafenib were partial response in 2 of 15 (13%), stable disease in 10 of 15 (67%), and progressive disease in 3 of 15 (20%) patients. With salvage therapy, partial responses were seen in 7 of 17 (41%) and stable disease in 10 of 17 (59%) patients. Median progression-free survival was 7.4 months with first-line sorafenib and 11.4 months with salvage therapy. Salvage therapy included sunitinib (n = 4), pazopanib (n = 3), cabozantinib (n = 4), lenvatinib (n = 3), and vemurafenib (n = 3). Conclusions: Other targeted agents are effective salvage treatments after sorafenib failure, despite similar mechanisms of action, and should be offered to patients who are able to receive salvage therapy.
language: eng
source:
identifier: ISSN: 0021-972X
fulltext: no_fulltext
issn:
  • 0021-972X
  • 1945-7197
url: Link


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titleRole of Salvage Targeted Therapy in Differentiated Thyroid Cancer Patients Who Failed First-Line Sorafenib
creatorDadu, Ramona ; Devine, Catherine ; Hernandez, Mike ; Waguespack, Steven G ; Busaidy, Naifa L ; Hu, Mimi I ; Jimenez, Camilo ; Habra, Mouhammad A ; Sellin, Rena V ; Ying, Anita K ; Cote, Gilbert J ; Sherman, Steven I ; Cabanillas, Maria E
creatorcontribDadu, Ramona ; Devine, Catherine ; Hernandez, Mike ; Waguespack, Steven G ; Busaidy, Naifa L ; Hu, Mimi I ; Jimenez, Camilo ; Habra, Mouhammad A ; Sellin, Rena V ; Ying, Anita K ; Cote, Gilbert J ; Sherman, Steven I ; Cabanillas, Maria E
descriptionContext: Sorafenib, a tyrosine kinase inhibitor, is a common first-line therapy for advanced differentiated thyroid cancer (DTC). However, responses are not durable and drug toxicity remains a problem. Objective: The objective of the study was to determine the efficacy of salvage therapy after first-line sorafenib failure. Design: This was a retrospective review at M. D. Anderson Cancer Center from January 2005 to May 2013. Patients: The study included patients with metastatic DTC who received salvage therapy after their initial sorafenib failure (group 2). Patients who received first-line sorafenib only (group 1) were evaluated for comparison of overall survival (OS). Outcome Measures: Progression-free survival, best response, and median OS were measured. Results: Sixty-four patients with metastatic, radioactive iodine refractory DTC were included; 35 were in group 1 and 25 were in group 2, and the groups were well balanced. Median OS of all 64 patients receiving first line sorafenib was 37 months; median OS was significantly longer with salvage therapy compared with sorafenib alone (58 vs 28 months, P = .013). In group 2, 17 patients were evaluable for best response, although two patients had toxicity with sorafenib, which was discontinued before restaging. Best responses with first-line sorafenib were partial response in 2 of 15 (13%), stable disease in 10 of 15 (67%), and progressive disease in 3 of 15 (20%) patients. With salvage therapy, partial responses were seen in 7 of 17 (41%) and stable disease in 10 of 17 (59%) patients. Median progression-free survival was 7.4 months with first-line sorafenib and 11.4 months with salvage therapy. Salvage therapy included sunitinib (n = 4), pazopanib (n = 3), cabozantinib (n = 4), lenvatinib (n = 3), and vemurafenib (n = 3). Conclusions: Other targeted agents are effective salvage treatments after sorafenib failure, despite similar mechanisms of action, and should be offered to patients who are able to receive salvage therapy.
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subjectAbridged Index Medicus ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Carcinoma, Papillary, Follicular - drug therapy ; Carcinoma, Papillary, Follicular - mortality ; Carcinoma, Papillary, Follicular - pathology ; Chemotherapy, Adjuvant ; Drug Resistance, Neoplasm - drug effects ; Endocrine Care ; Female ; Humans ; Male ; Middle Aged ; Molecular Targeted Therapy ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Niacinamide - analogs & derivatives ; Niacinamide - therapeutic use ; Phenylurea Compounds - therapeutic use ; Protein Kinase Inhibitors - therapeutic use ; Retrospective Studies ; Salvage Therapy - methods ; Thyroid Neoplasms - drug therapy ; Thyroid Neoplasms - mortality ; Thyroid Neoplasms - pathology ; Treatment Failure
ispartofThe journal of clinical endocrinology and metabolism, 2014-06, Vol.99 (6), p.2086-2094
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1Devine, Catherine
2Hernandez, Mike
3Waguespack, Steven G
4Busaidy, Naifa L
5Hu, Mimi I
6Jimenez, Camilo
7Habra, Mouhammad A
8Sellin, Rena V
9Ying, Anita K
10Cote, Gilbert J
11Sherman, Steven I
12Cabanillas, Maria E
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descriptionContext: Sorafenib, a tyrosine kinase inhibitor, is a common first-line therapy for advanced differentiated thyroid cancer (DTC). However, responses are not durable and drug toxicity remains a problem. Objective: The objective of the study was to determine the efficacy of salvage therapy after first-line sorafenib failure. Design: This was a retrospective review at M. D. Anderson Cancer Center from January 2005 to May 2013. Patients: The study included patients with metastatic DTC who received salvage therapy after their initial sorafenib failure (group 2). Patients who received first-line sorafenib only (group 1) were evaluated for comparison of overall survival (OS). Outcome Measures: Progression-free survival, best response, and median OS were measured. Results: Sixty-four patients with metastatic, radioactive iodine refractory DTC were included; 35 were in group 1 and 25 were in group 2, and the groups were well balanced. Median OS of all 64 patients receiving first line sorafenib was 37 months; median OS was significantly longer with salvage therapy compared with sorafenib alone (58 vs 28 months, P = .013). In group 2, 17 patients were evaluable for best response, although two patients had toxicity with sorafenib, which was discontinued before restaging. Best responses with first-line sorafenib were partial response in 2 of 15 (13%), stable disease in 10 of 15 (67%), and progressive disease in 3 of 15 (20%) patients. With salvage therapy, partial responses were seen in 7 of 17 (41%) and stable disease in 10 of 17 (59%) patients. Median progression-free survival was 7.4 months with first-line sorafenib and 11.4 months with salvage therapy. Salvage therapy included sunitinib (n = 4), pazopanib (n = 3), cabozantinib (n = 4), lenvatinib (n = 3), and vemurafenib (n = 3). Conclusions: Other targeted agents are effective salvage treatments after sorafenib failure, despite similar mechanisms of action, and should be offered to patients who are able to receive salvage therapy.
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4Carcinoma, Papillary, Follicular - drug therapy
5Carcinoma, Papillary, Follicular - mortality
6Carcinoma, Papillary, Follicular - pathology
7Chemotherapy, Adjuvant
8Drug Resistance, Neoplasm - drug effects
9Endocrine Care
10Female
11Humans
12Male
13Middle Aged
14Molecular Targeted Therapy
15Neoadjuvant Therapy
16Neoplasm Metastasis
17Niacinamide - analogs & derivatives
18Niacinamide - therapeutic use
19Phenylurea Compounds - therapeutic use
20Protein Kinase Inhibitors - therapeutic use
21Retrospective Studies
22Salvage Therapy - methods
23Thyroid Neoplasms - drug therapy
24Thyroid Neoplasms - mortality
25Thyroid Neoplasms - pathology
26Treatment Failure
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6Jimenez, Camilo
7Habra, Mouhammad A
8Sellin, Rena V
9Ying, Anita K
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titleRole of Salvage Targeted Therapy in Differentiated Thyroid Cancer Patients Who Failed First-Line Sorafenib
authorDadu, Ramona ; Devine, Catherine ; Hernandez, Mike ; Waguespack, Steven G ; Busaidy, Naifa L ; Hu, Mimi I ; Jimenez, Camilo ; Habra, Mouhammad A ; Sellin, Rena V ; Ying, Anita K ; Cote, Gilbert J ; Sherman, Steven I ; Cabanillas, Maria E
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0Abridged Index Medicus
1Adult
2Aged
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4Carcinoma, Papillary, Follicular - drug therapy
5Carcinoma, Papillary, Follicular - mortality
6Carcinoma, Papillary, Follicular - pathology
7Chemotherapy, Adjuvant
8Drug Resistance, Neoplasm - drug effects
9Endocrine Care
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11Humans
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14Molecular Targeted Therapy
15Neoadjuvant Therapy
16Neoplasm Metastasis
17Niacinamide - analogs & derivatives
18Niacinamide - therapeutic use
19Phenylurea Compounds - therapeutic use
20Protein Kinase Inhibitors - therapeutic use
21Retrospective Studies
22Salvage Therapy - methods
23Thyroid Neoplasms - drug therapy
24Thyroid Neoplasms - mortality
25Thyroid Neoplasms - pathology
26Treatment Failure
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1Devine, Catherine
2Hernandez, Mike
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4Busaidy, Naifa L
5Hu, Mimi I
6Jimenez, Camilo
7Habra, Mouhammad A
8Sellin, Rena V
9Ying, Anita K
10Cote, Gilbert J
11Sherman, Steven I
12Cabanillas, Maria E
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notesThis work was supported by the National Institutes of Health/National Cancer Institute under Award P30CA016672.
abstractContext: Sorafenib, a tyrosine kinase inhibitor, is a common first-line therapy for advanced differentiated thyroid cancer (DTC). However, responses are not durable and drug toxicity remains a problem. Objective: The objective of the study was to determine the efficacy of salvage therapy after first-line sorafenib failure. Design: This was a retrospective review at M. D. Anderson Cancer Center from January 2005 to May 2013. Patients: The study included patients with metastatic DTC who received salvage therapy after their initial sorafenib failure (group 2). Patients who received first-line sorafenib only (group 1) were evaluated for comparison of overall survival (OS). Outcome Measures: Progression-free survival, best response, and median OS were measured. Results: Sixty-four patients with metastatic, radioactive iodine refractory DTC were included; 35 were in group 1 and 25 were in group 2, and the groups were well balanced. Median OS of all 64 patients receiving first line sorafenib was 37 months; median OS was significantly longer with salvage therapy compared with sorafenib alone (58 vs 28 months, P = .013). In group 2, 17 patients were evaluable for best response, although two patients had toxicity with sorafenib, which was discontinued before restaging. Best responses with first-line sorafenib were partial response in 2 of 15 (13%), stable disease in 10 of 15 (67%), and progressive disease in 3 of 15 (20%) patients. With salvage therapy, partial responses were seen in 7 of 17 (41%) and stable disease in 10 of 17 (59%) patients. Median progression-free survival was 7.4 months with first-line sorafenib and 11.4 months with salvage therapy. Salvage therapy included sunitinib (n = 4), pazopanib (n = 3), cabozantinib (n = 4), lenvatinib (n = 3), and vemurafenib (n = 3). Conclusions: Other targeted agents are effective salvage treatments after sorafenib failure, despite similar mechanisms of action, and should be offered to patients who are able to receive salvage therapy.
copUnited States
pubEndocrine Society
pmid24628550
doi10.1210/jc.2013-3588
oafree_for_read