ECE2015 Eposter Presentations Thyroid cancer (90 abstracts)
Chemotherapy effectiveness in the treatment of non-medullary well-differentiated thyroid cancer: a systematic and case review
Ana Albero 1 , Esther Martín 2 , Alberto Torres 3 , Teresa García 1 , Natividad Gonzalez 3 , María de Carmen del Alamo 1 , Luis de la Cruz 1 & Tomás Martín 3
1Department of Oncology, Hospital Virgen Macarena, Seville, Spain; 2Andalusian Agency for Health Technology Assessment, Seville, Spain; 3Department of Endocrinology and Nutrition, Hospital Virgen Macarena, Seville, Spain.
Introduction: Nowadays, use of chemotherapy in well-differentiated non medullary thyroid cancer, locally advanced stage and/or with radioiodine-refractory metastases is considered of scanty value. However, in the last 40 years was not published any phase III study nor a systematic review of its use in clinical setting.
Methods: A systematic literature search was performed in databases such as Medline and Embase, among others. Two independent reviewers analysed the articles selected full text, made a critical reading and extracted results using forms designed specifically. A qualitative synthesis of the results was performed and the accumulated data were calculated.
Results: A total of 509 references were found. Sixteen studies involving 473 patients published were included. Thirteen studies showed individual response data to treatment. Finally, 179 patients treated with different chemotherapy alone or in combination were identified. The overall response rate (IR) was 27% (0–57%), with a 4% of patients showed a complete response (CR) and clinical benefit (CB) in 60% (14–100%). Eight studies reported data response relative to histologic subtype. The IR for the 37 cases with papillary cancer was 24% (0–50%) and 32% (5% CR) (0–100%) of 56 with follicular cancer. However, data must be interpreted carefully due to the risk of bias detected. Unlike modern studies a performance status >2 was described in about 40% of patients. Five individual studies published survival data from 54 patients with advanced CDT: the median survival was estimated at 18 months (95% CI 0–37.5), with significant differences between patients treated before 2000 vs those treated later (7 months vs 41 months, P<0.00).
Conclusion: There are insufficient data to evaluate the effectiveness of chemotherapy in patients with advanced non-medullary thyroid cancer, although, it seems to have some efficacy, therefore, it could be necessary to be tested in well-designed studies vs or in combination with new therapies.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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