Abstract 2104
Background
Tyrosine kinase inhibitor-induced hypothyroidism is associated with favorable survival in patients with various cancers. We aimed to investigate the incidence of regorafenib-induced hypothyroidism and assess its prognostic value in patients with metastatic or unresectable colorectal cancer (CRC) receiving regorafenib.
Methods
This study included 68 patients with metastatic or unresectable CRC refractory to standard therapies from Asan Medical Center between 2014 and 2016. Regorafenib (160 mg/day on days 1–21, following a 7-day break) was administered.
Results
The median patient age was 58 (range, 26–72) years, and 61.8% of patients were male. Among the 68 patients, 50 (73.5%) showed hypothyroidism [subclinical hypothyroidism in 39 (57.4%) and symptomatic hypothyroidism in 11 (16.2%)]. Thyroid hormone replacement relieved fatigue, and the thyroid stimulating hormone level stabilized in patients with symptomatic hypothyroidism. Overall, the objective response rate (ORR) and disease control rate (DCR) were 7.4% and 70.6%, respectively, and were significantly higher in patients with symptomatic or subclinical hypothyroidism than in those with a euthyroid status (ORR: 27.3% vs. 5.1% vs. 0.0%, P = 0.001; DCR: 100% vs. 76.9% vs. 38.9%, P = 0.001). Median progression-free survival (PFS) and overall survival (OS) were longer in patients with symptomatic hypothyroidism than in those with subclinical hypothyroidism (median PFS: 9.1 vs. 3.8 months, P = 0.018; median OS: 19.2 vs. 9.4 months, P = 0.012) or those with a euthyroid status (median PFS: 9.1 vs. 1.8 months, P < 0.001; median OS: 19.2 vs. 4.7 months, P = 0.001). The occurrence of symptomatic hypothyroidism was a significant protective factor for PFS [hazard ratio (HR)=0.37, P = 0.006] and OS (HR = 0.35, P = 0.007).
Conclusions
As regorafenib-induced hypothyroidism occurs frequently and is associated with better survival in patients with metastatic CRC receiving regorafenib, active monitoring of the thyroid function status is necessary during regorafenib treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1025 - Liver metastases (LM) from intrahepatic cholangiocarcinoma (iCCA): Outcomes from the European Network for the Study of Cholangiocarcinoma (ENS-CCA) registry and implications on current American Joint Committee on Cancer (AJCC) staging.
Presenter: Angela Lamarca
Session: Poster Display session 2
Resources:
Abstract
5813 - Is MGMT methylation a new therapeutic target for Biliary Tract Cancer?
Presenter: Monica Niger
Session: Poster Display session 2
Resources:
Abstract
5839 - Biliary Tract Cancers in Portuguese families with BRCA gene mutation: a retrospective study.
Presenter: Patricia Pereira
Session: Poster Display session 2
Resources:
Abstract
4338 - Selection of patients with hepatocellular carcinoma for selective internal radiation therapy based on tumour burden and liver function: a post-hoc analysis of the SARAH trial
Presenter: Daniel Palmer
Session: Poster Display session 2
Resources:
Abstract
1700 - Second-line chemotherapy (SLC) in Patients with Advanced Biliary tract and Gallbladder Cancers (ABGC) Prolongs Survival: A Retrospective Population-based Cohort Study
Presenter: Adnan Zaidi
Session: Poster Display session 2
Resources:
Abstract
5562 - Overall survival of patients with hepatocellular carcinoma receiving sorafenib versus selective internal radiation therapy with predicted dosimetry in the SARAH trial
Presenter: Neil Hawkins
Session: Poster Display session 2
Resources:
Abstract
1838 - Multicenter phase II trial of axitinib monotherapy for advanced biliary tract cancer refractory to gemcitabine-based chemotherapy
Presenter: Naohiro Okano
Session: Poster Display session 2
Resources:
Abstract
3641 - Soluble Programmed Death-ligand 1 indicate poor prognosis in hepatocellular carcinoma patients undergoing transcatheter arterial chemoembolization
Presenter: Xiaolu Ma
Session: Poster Display session 2
Resources:
Abstract
2733 - The Prognostic Nutritional Index (PNI) is an independent predictor of survival in advanced biliary cancers (ABC) receiving first-line chemotherapy (1L).
Presenter: Francesco Caputo
Session: Poster Display session 2
Resources:
Abstract
3773 - Impact of centralisation of national cancer services on patient outcomes for hepatobiliary cancers in Ireland 2000 – 2016
Presenter: David O Reilly
Session: Poster Display session 2
Resources:
Abstract