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Lenvatinib: Role in thyroid cancer and other solid tumors

Maria E Cabanillas1, Mouhammed Amir Habra1

  • 1The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Cancer Treatment Reviews
|December 19, 2015
PubMed

Insights

Lenvatinib shows significant promise for advanced thyroid cancer. This tyrosine kinase inhibitor demonstrated improved progression-free survival and response rates in differentiated thyroid cancer patients, offering a new treatment option.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Advanced thyroid cancers, including differentiated thyroid cancer (DTC) and medullary thyroid cancer (MTC), have poor prognoses with limited treatment options.
  • Small-molecule tyrosine kinase inhibitors (TKIs) are emerging as effective treatments for advanced thyroid cancer.
  • Lenvatinib is an FDA-approved TKI for radioactive iodine (RAI)-refractory DTC.

Purpose of the Study:

  • To evaluate the efficacy and safety of lenvatinib in patients with advanced, progressive, RAI-refractory differentiated thyroid cancer (DTC).
  • To assess lenvatinib's antitumor activity and therapeutic potential in advanced thyroid cancer.

Main Methods:

  • Lenvatinib targets multiple receptor tyrosine kinases, including VEGFRs, FGFRs, RET, c-kit, and PDGFRα.
  • Clinical trials (Phase II and III) investigated lenvatinib's efficacy in advanced RAI-refractory DTC and Phase II in MTC.
  • Antitumor activity is attributed to antiangiogenic properties and direct antitumor effects.

Main Results:

  • In a Phase II study of advanced RAI-refractory DTC, lenvatinib achieved a 50% response rate (RR) and 12.6 months median progression-free survival (PFS).
  • A Phase III trial showed lenvatinib significantly improved median PFS to 18.3 months and overall RR to 65% in RAI-refractory DTC compared to placebo (3.6 months PFS, 2% RR).
  • Common adverse events (>50%) included hypertension, diarrhea, fatigue/asthenia, and decreased appetite.

Conclusions:

  • Lenvatinib demonstrates significant clinical benefit and antitumor activity in patients with advanced, RAI-refractory differentiated thyroid cancer.
  • Lenvatinib represents a promising therapeutic option for managing advanced thyroid cancer, offering improved survival outcomes.
  • Further investigation into lenvatinib's role in medullary thyroid cancer and other advanced thyroid cancer subtypes may be warranted.
Keywords:
AdvancedDifferentiatedMedullaryMultikinaseRefractorySurvival

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