Lung cavitation in patients with anaplastic thyroid cancer treated with lenvatinib
Daisuke Murayama1, Yayoi Yamamoto2, Ai Matsui1
1Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Background:
Anaplastic thyroid cancer (ATC) is a rare malignancy with a poor prognosis. It accounts for 1-2% of all thyroid cancers. Lenvatinib is an orally administered inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, and -3, fibroblast growth factor receptor (FGFR)-1 to -4, platelet-derived growth factor receptor (PDGFR)-α, rearranged during transfection (RET), and KIT. There have been cases of pneumothorax caused by lung cavitation and collapse after administration of lenvatinib in ATC with lung metastasis. In this study, we investigate lung cavitation during treatment with lenvatinib in ATC patients with lung metastasis.
Methods:
All ATC patients with lung metastasis treated at our hospital with lenvatinib between November 2015 and May 2021 were selected from our electronic medical records. The primary objective was to determine the incidence of cavitation of lung metastasis of ATC in patients treated with lenvatinib. The secondary objective was to evaluate prognostic factors in ATC patients with lung metastasis treated with lenvatinib.
Results:
We identified 26 patients treated with lenvatinib for ATC with lung metastasis. Of these, 12 (46.2%) had cavitation with lung metastasis during lenvatinib treatment. The median overall survival (OS) was 128 days (79-228 days), and the cavitation (+) group had significantly longer OS than the cavitation (-) group [186 days (117-355 days) vs. 89 days (59-179 days), P=0.033]. Kaplan-Meier survival curves indicated a significant difference in OS was observed between the two groups (P=0.0293). Univariate analysis demonstrated lung cavitation was a significant prognostic factor (hazard ratio: 0.38, 95% CI: 0.16-0.93).
Conclusions:
Lung cavitation occurred in 46.2% of patients treated with lenvatinib for ATC with lung metastasis. Patients who developed lung cavitation had a significantly better prognosis than those who did not.
Insights
Lung cavitation occurred in 46.2% of anaplastic thyroid cancer (ATC) patients treated with lenvatinib. This finding suggests lung cavitation is a positive prognostic indicator for overall survival in ATC patients with lung metastasis.
Area of Science:
- Oncology
- Pharmacology
Background:
- Anaplastic thyroid cancer (ATC) is a rare, aggressive thyroid malignancy with a poor prognosis, accounting for 1-2% of all thyroid cancers.
- Lenvatinib is a multi-targeted tyrosine kinase inhibitor used in treating various cancers, including ATC.
- Lung cavitation and collapse have been observed as potential complications of lenvatinib treatment in ATC patients with lung metastasis.
Purpose of the Study:
- To determine the incidence of lung cavitation in patients with ATC and lung metastasis treated with lenvatinib.
- To evaluate the prognostic significance of lung cavitation in this patient cohort.
Main Methods:
- Retrospective analysis of electronic medical records for ATC patients with lung metastasis treated with lenvatinib from November 2015 to May 2021.
- Primary objective: Incidence of lung cavitation.
- Secondary objective: Evaluation of prognostic factors, including overall survival.
Main Results:
- Of 26 patients, 12 (46.2%) developed lung cavitation during lenvatinib treatment.
- Patients with cavitation had significantly longer median overall survival (186 days vs. 89 days, P=0.033).
- Univariate analysis identified lung cavitation as a significant positive prognostic factor (HR: 0.38).
Conclusions:
- Lung cavitation is a frequent occurrence in ATC patients with lung metastasis treated with lenvatinib.
- The development of lung cavitation is associated with a significantly improved prognosis and longer overall survival.
