Abstract 571P
Background
Lenvatinib (Len) was approved by the FDA and EMA as 1st-line treatment for rDTC pts. This study aims to describe the efficacy and toxicity of Len treatment in a monocentric real-life multidisciplinary-based management of rDTC pts.
Methods
Medical records of 49 consecutive pts with histologically/cytologically diagnosis of DTC and progressive disease, treated with Len between July 2015 and December 2020, were collected. Treatment was validated by multidisciplinary local board (oncologist, endocrinologist, radiotherapist, endocrine surgeon, nuclear medicine physician); all pts were managed by an oncologist and/or by an endocrinologist at Unità Tumori Ereditari-IOV-IRCCS, Padova, Italy.
Results
All 49 pts (24M/25F) were considered; median age at Len initiation was 72 ys (51-87). All pts were metastatic (lung 87%, bones 38%, lymphnodes 59%, liver 14%, brain 4%, kidney 2%); for 44 pts (90%) Len was the 1st systemic treatment and 14 pts (28%) had cancer-related symptoms at treatment initiation. With median duration of treatment of 14.2 months (1.7-60.9), median Progressione Free Survival (PFS) was 31.2 months (95% CI, 19-N.D.) and 24 months Overall Survival (OS) was 75.3%. Best response was partial response in 30 pts (61.2%) and stable disease in 14 pts (28.6%); no complete responses were observed. Almost all pts (98%) experienced Adverse Events (AEs) and 53% developed grade 3 AEs. The most frequent AEs were hypertension (84% all grade, 45% grade 3), fatigue 57%, weight loss 43%, diarrhea 33%, mucositis 43%, skin 43%. No grade 4 AEs or treatment-related deaths were observed. Dose reduction for AEs was needed for 22 pts (44%); 39 pts (79%) interrupted Len with a median dose interruption of 3.3% compared with total treatment duration.
Conclusions
Higher PFS (and OS) observed in this study, compared with other Clinical trials, is probably due to fewer pts needing dose reductions, shorter time of treatment interruption and fewer pts with cancer-related symptoms at Len initiation. Hence, a multidisciplinary approach could lead to establish appropriate timing for Len initiation and may allow the early detection and better management of AE.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S. Zovato: Financial Interests, Institutional, Advisory Board: Eisai ; Financial Interests, Institutional, Advisory Board: Lilly. E. Mioranza: Financial Interests, Institutional, Advisory Board: Novartis; Financial Interests, Institutional, Advisory Board: Lilly. G. Crivellari: Financial Interests, Institutional, Advisory Board: Eisai s; Financial Interests, Personal, Ownership Interest: Novartis; Financial Interests, Personal, Ownership Interest: ROCHE. All other authors have declared no conflicts of interest.