Efficacy of sorafenib and impact on cardiac function in patients with thyroid cancer: a retrospective analysis
1Endocrine Unit, IRCSS IST-San Martino University Hospital, 16132, Genoa, Italy, lollom@hotmail.it.
Purpose:
Sorafenib has recently been recognized as an important standard option for the management of patients with differentiated thyroid cancer. Although data concerning cardiac safety are available in pan-tumor studies, no data are available on its use in everyday clinical practice in patients with thyroid cancer.
Methods:
In the off-label program of our institution, we enrolled 14 patients with different histological types of thyroid cancer suitable for treatment with sorafenib. Our aims were to evaluate cardiac safety factors-LVEF (left ventricular ejection fraction), heart rate and blood pressure-the cardiac markers NT-proBNP and troponin I, radiological response evaluated by CT and (18)FDG-PET (according to RECIST 1.1 criteria) and biomarker reduction (Eastern Cooperative Oncology Group Performance Status: ECOG PS) 0-2.
Results:
Patients with ECOG PS 2 accounted for 36%. After starting sorafenib, many patients displayed reduced or stabilized metabolic activity in target lesions (clinical benefit = 44%), radiologic reduction or stabilization (74%) and decreased cancer markers (90%). Lung metastases displayed the largest reductions in size. Median overall survival (OS) was 7 months and median progression-free survival (PFS) was 3 months. No sign of cardiotoxicity was observed in almost all patients. LVEF was altered in two patients and proved symptomatic in one.
Conclusions:
Sorafenib seems to be effective in reducing disease progression in the early stages of treatment (3-6 months). Responses varied considerably according to the criteria investigated. Cardiac toxicities did not raise concerns and were in line with data reported in other malignancies. However, cardiac monitoring is recommended.
Insights
Sorafenib shows effectiveness in managing differentiated thyroid cancer, with notable reductions in disease progression and cancer markers. Cardiac safety was generally good, with minimal cardiotoxicity observed in patients during this study.
Area of Science:
- Oncology
- Cardiology
- Pharmacology
Background:
- Sorafenib is a recognized treatment for differentiated thyroid cancer.
- Limited data exist on sorafenib's cardiac safety in clinical practice for thyroid cancer patients.
Purpose of the Study:
- Evaluate cardiac safety of sorafenib in thyroid cancer patients.
- Assess radiological and biomarker response to sorafenib.
- Determine overall and progression-free survival.
Main Methods:
- 14 thyroid cancer patients received off-label sorafenib.
- Cardiac safety assessed via LVEF, heart rate, blood pressure, NT-proBNP, and troponin I.
- Radiological response evaluated by CT and (18)FDG-PET; biomarker reduction also assessed.
Main Results:
- 44% showed clinical benefit; 74% had radiological reduction/stabilization.
- 90% experienced decreased cancer markers; lung metastases showed significant size reduction.
- Median OS was 7 months, median PFS was 3 months.
- Minimal cardiotoxicity observed; LVEF altered in 2 patients, symptomatic in 1.
Conclusions:
- Sorafenib effectively reduces disease progression in early-stage thyroid cancer.
- Responses varied, but cardiac toxicities were not a major concern.
- Cardiac monitoring is recommended despite favorable safety profile.
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