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Evaluating the effectiveness of targeted therapies for thyroid carcinoma: an updated meta-analysis
Shuai Lin1,2, Jun Shen3, Wanjun Zhao1
1Thyroid and Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu 610041, China.
Background:
At present, most of the targeted therapies for thyroid carcinoma are in the clinical trial stage, and there is still no strong evidence to confirm their clinical effect. The aim of this meta-analysis was to evaluate the outcome of targeted therapies and provide quantitative evidence.
Method:
Ovid, PubMed, EMBAS, ClinicalTrails.gov, and Cochrane Library electronic databases were searched until September 1, 2019. Randomized controlled studies (RCTs) studies that compared the treatment of thyroid carcinoma with the targeted therapies of utility and complications were analyzed.
Results:
The study included 5 studies with a total of 1,615 patients, with 991 cases in the drug group and 624 cases in the placebo group. The meta-analysis indicated that compared with the placebo group, the progression-free survival (PFS) rate of the drug group was significantly improved. The PFS of the drug group was 10.8 to 30.5 months, compared with 4 to 19.3 months for the placebo group (6 months PFS: OR =3.23, 95% CI: 2.57 to 4.05, P<0.00001, 12 months PFS: OR =3.38, 95% CI: 2.58 to 4.42, P<0.00001, 18 months PFS: OR =2.48, 95% CI: 1.74 to 3.54, P<0.00001). Overall survival (OS) did not differ significantly in the study (6 months: OR =1.53, 95% CI: 1.00 to 2.35, P=0.05, 12 months: OR =1.26, 95% CI: 0.94 to 1.69, P=0.12, 18 months: OR =1.11, 95% CI: 0.87 to 1.42, P=0.39). The incidence of adverse reactions in the drug group was significantly higher than that in the placebo group (OR =4.76, 95% CI: 3.45 to 6.57, P<0.00001), and the subgroup of adverse reactions was still significantly higher than that in the placebo group.
Conclusions:
This meta-analysis revealed that the targeted drugs can significantly prolong PFS in patients with thyroid carcinoma, but the targeted drugs did not prolong the OS. Although the incidence of adverse reactions was significantly higher than that of the placebo group, the patients were still tolerable in drug group.
Insights
Targeted therapies significantly improve progression-free survival (PFS) in thyroid cancer patients but do not extend overall survival (OS). While adverse reactions are more common, they remain tolerable.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- Thyroid carcinoma treatments are largely experimental, lacking robust evidence of clinical efficacy.
- Targeted therapies show promise but require further evaluation.
Purpose of the Study:
- To conduct a meta-analysis evaluating the efficacy and safety of targeted therapies for thyroid carcinoma.
- To provide quantitative evidence on the outcomes of targeted treatments.
Main Methods:
- A systematic search of Ovid, PubMed, EMBAS, ClinicalTrials.gov, and Cochrane Library databases up to September 1, 2019.
- Inclusion of randomized controlled trials (RCTs) comparing targeted therapies against placebo for thyroid carcinoma.
- Analysis of treatment utility and complications.
Main Results:
- Five RCTs involving 1,615 patients (991 drug, 624 placebo) were analyzed.
- Targeted therapies significantly improved progression-free survival (PFS) at 6, 12, and 18 months (P<0.00001).
- No significant difference in overall survival (OS) was observed; however, adverse reactions were significantly higher in the drug group (P<0.00001).
Conclusions:
- Targeted drugs significantly prolong PFS in thyroid carcinoma patients.
- Overall survival (OS) was not significantly improved by targeted therapies.
- Despite increased adverse reactions, patients generally tolerated the targeted treatments.
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