Endocrine Abstracts

Purpose: To establish the safety and efficacy of multikinase inhibitors (MKIs) treatment in real life.

Methods: This retrospective observational descriptive study included patients with advanced differentiated thyroid cancer in treatment with MKIs as first and second line treatment. From November 2011 to May 2022. Clinical variables, efficacy and adverse events (AE) were collected. Variables are expressed as median and interquartile range.

Results: First line. n=30. 21 sorafenib, 6 lenvatinib, 2 axitinib, 1 pazopanib. Second line, n=11 lenvatinib. 46.7% were women. Papillary thyroid cancer 73.3%. Age of onset of MKIs 67 years. Time from metastasis to IMK start 24 (9.2–74) months. Lung metastasis 66.7%, bone metastasis 3.3%, lung and bone metastasis 20%.

Safety: AEs occurred in 96.7% of patients in first line treatment. The most common was asthenia in 70% of patients. Severe AE, grade 3 or 4, occurred in 30% of patients, the most common was palmar-plantar erythrodysesthesia syndrome. All patients in second line of treatment presented AEs. Asthenia was the most common AE (72.7%) followed by hypertension (63.6%). Severe AE occurred in 54.5% of patients.

Efficacy: MKIs as first line. The median progression-free survival (PFS) was 23 months (CI 95% 11.2–34.8). Median overall survival (OS) was not reached. Mean overall survival was 71.13 months (CI 52–90.1). Median duration of treatment 331 days. Sorafenib as first line. Median PFS was 16 months (CI 95% 4.8–27.2). Median overall survival (OS) was not reached. Mean overall survival was 64.3 months (CI 42.5–86.2). 3 patients died. Dose withdrawal because of AE occurred in 10 (47.6%) of patients. The rest had disease progression. Lenvatinib as first line. Median PFS was not reached. 1 patient died and 5 patients had not disease progression. Median duration of treatment 383 days. Lenvatinib as second line. Median PFS was 24 months (CI 16.6–31.4). Median overall survival (OS) was not reached. Mean overall survival was 36.3 months (CI 30.9–42.2). 2 patients died. Dose withdrawal because of AE occurred in 5 (45.5%) of patients who had disease progression. 2 patients suffered disease progression. Partial response occurred in 1 patient, 1 had stable disease.

Conclusions: With Lenvatinib as first line treatment, most patients reached stable disease. With sorafenib as first line treatment we got similar results to clinical trials. AE were common, 30% as first line and 54.5% as second line.