Related Experiment Video
Updated: Jun 12, 2025
Pretargeted Radioimmunotherapy Based on the Inverse Electron Demand Diels-Alder Reaction
Published on: January 29, 2019
Efficacy and Safety of Targeted Therapy for Radioiodine-Refractory Differentiated Thyroid Cancer
Yuqing Zhang1, Xiaoxin Zhang2, Lifan Lin3
1School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China.
Context:
There has been considerable success in the development of drugs for targeted therapy of radioiodine-refractory differentiated thyroid cancer (RR-DTC) and to know the safety and efficacy of these drugs will help their appropriate application.
Objective:
To evaluate the efficacy and safety of current targeted drug therapies for radioiodine-refractory differentiated thyroid cancer.
Methods:
This was a meta-analysis of relevant randomized controlled trials (RCTs) and single-arm studies searched across PubMed, Embase, Cochranes, and Web of Sciences up to September 12, 2023. Stata15.0 software was used to assess overall survival (OS), progression-free survival (PFS), disease control rate (DCR), objective response rate (ORR), and adverse events. The Cochrane Bias Risk tool was used to assess literature quality and trial bias and RevMan 5.4 was used to generate a quality assessment map.
Results:
A total of 8 RCTs and 17 single-arm studies with 3270 patients on 7 drugs-vandetanib, sorafenib, lenvatinib, cabozantinib, apatinib, donafenib, and anlotinib-were included. Targeted therapy with these drugs effectively prolonged PFS and OS in patients with RR-DTC with overall hazard ratios of 0.35 (95% CI 0.23-0.53, P < .00001) and 0.53 (95% CI 0.32-0.86, P < .00001), respectively. ORR and DCR were also prolonged, with overall risk ratios of 27.63 (95% CI 12.39-61.61, P < .00001) and 1.66 (95% CI 1.48-1.86, P < .00001), respectively. The subgroup analysis using effect size (ES) showed that apatinib had the best effect on ORR with an ES of 0.66 (95% CI 0.49-0.83, P < .00001) and DCR with a ES of 0.95 (95% CI 0.91-1.00, P < .00001). Common drug adverse events included hypertension, diarrhea, proteinuria, and fatigue.
Conclusion:
The currently used targeted drug therapies for RR-DTC can significantly improve clinical outcomes, and the new drug apatinib demonstrates promise for potentially superior performance.
Insights
Targeted drug therapies significantly improve outcomes for radioiodine-refractory differentiated thyroid cancer (RR-DTC). Apatinib shows promise for superior efficacy in RR-DTC treatment.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- Radioiodine-refractory differentiated thyroid cancer (RR-DTC) presents a therapeutic challenge.
- Targeted drug therapies have emerged as a promising treatment modality for RR-DTC.
- Evaluating the safety and efficacy of these therapies is crucial for optimal patient care.
Purpose of the Study:
- To conduct a meta-analysis evaluating the efficacy and safety of targeted drug therapies for RR-DTC.
- To synthesize evidence from randomized controlled trials (RCTs) and single-arm studies.
- To identify drugs with the most significant impact on clinical outcomes.
Main Methods:
- Meta-analysis of RCTs and single-arm studies sourced from major databases up to September 2023.
- Assessment of overall survival (OS), progression-free survival (PFS), disease control rate (DCR), and objective response rate (ORR).
- Evaluation of adverse events and literature quality using standardized tools (Cochrane Bias Risk, RevMan 5.4).
Main Results:
- Seven targeted drugs (vandetanib, sorafenib, lenvatinib, cabozantinib, apatinib, donafenib, anlotinib) were analyzed across 3270 patients.
- Significant improvements in PFS (HR 0.35) and OS (HR 0.53) were observed with targeted therapies.
- Apatinib demonstrated the highest efficacy for ORR (ES 0.66) and DCR (ES 0.95). Common adverse events included hypertension, diarrhea, proteinuria, and fatigue.
Conclusions:
- Current targeted drug therapies offer significant clinical benefits for patients with RR-DTC.
- Apatinib emerges as a potentially superior option for improving response rates and disease control.
- Further research may focus on optimizing apatinib use and managing its side effects.
