ECE2013 Poster Presentations Endocrine tumours and neoplasia (66 abstracts)
Sequential use of the kinase-inhibitors sorafenib and sunitinib in a patient affected with pluri-metastatic iodine-refractory follicular thyroid carcinoma
Vincenzo Marotta 1 , Valeria Ramundo 1 , Francesca Marciello 1 , Michela Del Prete 1 , Antonella Di Sarno 2 , Raffaella Esposito 1 , Annachiara Carratù 1 , Chiara de Luca di Roseto 1 , Luigi Camera 3 , Annamaria Colao 1 & Antongiulio Faggiano 4
1Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Naples, Italy; 2IX Infectious Disease and Interventional Ultrasound Unit, “D. Cotugno” Hospital, Naples, Italy; 3Department of Biomorphological and Functional Sciences, Federico II University, Naples, Italy; 4Endocrinology, National Cancer Institute, “Fondazione G. Pascale”, Naples, Italy.
Introduction: Kinase-inhibitors (KIs) are effective for treatment of most aggressive endocrine cancers. The crucial point about treatment with KIs is that these agents are not curative and their effects are at best transitory and are always followed by a restoration of tumour growth and progression. Several retrospective and phase II studies demonstrated efficacy of both sorafenib and sunitib for treatment of iodine refractory differentiated thyroid cancer although results from phase III trials are not available yet.
Case report: A 57 year old woman was affected with a pluri-metastatic iodine refractory follicular thyroid carcinoma. She presented multiple metastases in lymph nodes (both cervical and mediastinal), lung, liver, bone. Treatment with sorafenib was started and a radiological response was achieved (stable disease according to RECIST criteria). Nevertheless, effectiveness of sorafenib was not durable: progression of disease was restored after 7 months of treatment. Then treatment with sunitinib was started. Interestingly, sunitinib obtained a clear morphological regression of disease (partial response according to RECIST). At present treatment with sunitinib (lasting for 11 months) is still ongoing and disease is still not progressive.
Conclusions: KIs may lead to arrest of tumour progression and improvement of survival. However, disease is expected to escape during therapy. For this reason, to identify a therapeutic scheme based on a sequential use of different KIs could delay the development of tumor progression.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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