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Sorafenib in metastatic thyroid cancer

Jaume Capdevila1, Lara Iglesias, Irene Halperin

  • 1Medical Oncology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain. jacapdevila@vhebron.net

Endocrine-Related Cancer
|January 31, 2012
PubMed

Insights

Sorafenib demonstrated antitumor efficacy across all thyroid cancer subtypes, including differentiated, medullary, and anaplastic types, in a retrospective analysis of refractory metastatic thyroid cancer patients. This finding supports further investigation of sorafenib for advanced thyroid cancer treatment.

Area of Science:

  • Oncology
  • Pharmacology
  • Endocrinology

Background:

  • Thyroid cancer often has an excellent prognosis, but therapeutic options are limited for refractory cases.
  • Tyrosine kinase inhibitors (TKIs) show promise in early studies for advanced thyroid cancer.
  • Sorafenib is a TKI investigated for its efficacy in various advanced cancers.

Purpose of the Study:

  • To evaluate the efficacy and safety of sorafenib in patients with progressive metastatic thyroid cancer.
  • To assess objective response rate (RR), progression-free survival (PFS), and overall survival (OS).
  • To explore the correlation between tumor marker levels and treatment efficacy.

Main Methods:

  • Retrospective analysis of 34 patients with progressive metastatic thyroid cancer (papillary, follicular, medullary, anaplastic) treated with sorafenib (400 mg twice daily).
  • Patients were not candidates for curative surgery, radioactive-iodine therapy, or radiotherapy.
  • Data collected included objective response rate, toxicity, PFS, OS, and changes in tumor markers (thyroglobulin, calcitonin, CEA).

Main Results:

  • Overall, 11 patients (32%) achieved partial response and 14 (41%) had stable disease >6 months.
  • Response rates varied by subtype: 47% for medullary thyroid carcinoma (MTC), 19% for differentiated thyroid carcinoma (DTC), and 33% for anaplastic thyroid carcinoma (ATC).
  • Median PFS was 13.5 months for DTC, 10.5 months for MTC, and 4.4 months for ATC. A significant association was found between RR and >50% decrease in tumor markers (P=0.033).

Conclusions:

  • Sorafenib demonstrated antitumor activity in all histological subtypes of metastatic thyroid cancer.
  • The drug showed efficacy in refractory settings where other treatment options were exhausted.
  • Further clinical development of sorafenib for advanced thyroid cancer is warranted based on these findings.

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