ETA2023 Poster Presentations Treatment 1 (9 abstracts)
Evaluation of real-world efficacy in lenvatinib and pembrolizumab treated poorly (PDTC) and anaplastic (ATC) thyroid cancer patients
Tim Brandenburg 1 , Yara Maria Machlah 2 , Sarah Theurer 3 , Henning Dralle 4 , Manuel Weber 5 , Frank Weber 6 , Harald Lahner 7 & Dagmar Führer 8
1Department of Endocrinology, Diabetes and Metabolism and Division of Laboratory Research, University Hospital Essen, Essen, Germany, Endocrine Tumour Center at Wtz and Member of Endo-Ern and Euracan, Endokrinologie, Essen, Germany; 2University Hospital Essen, Department of Endocrinology, Diabetes and Metabolism, Endokrinologie, Diabetologie und Stoffwechsel, Essen, Germany; 3Universitätsklinikum Essen, Pathology, Department of Pathology, University Hospital Essen, Essen, Germany, Essen, Germany; 4University Hospital of Essen, Medical Centre, 2. Floor, Room 2.005, Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University Hospital Essen, Essen, Germany, Germany; 5Klinik für Nuklearmedizin, Department of Nuclear Medicine, University Hospital Essen, Essen, Germany, Essen, Germany; 6Klinik für Allgemeinchirurgie, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University Hospital Essen, Essen, Germany, Essen, Germany; 7Universitätsklinikum Essen, Klinik für Endokrinologie, Diabetologie und Stoffwechsel, Endokrinologie, Diabetologie und Stoffwechsel, Essen, Germany; 8Universitätsklinikum Essen, University Hospital Essen, Klinik für Endokrinologie und Stoffwechselerkrankungen, Essen, Germany
Anaplastic thyroid carcinoma (ATC) is a rare and aggressive malignancy with only limited effective systemic treatment options. The identification of actionable genetic lesions and its exploitation has expanded therapeutic approaches and especially for the subset of BRAFV600E mutated ATC (11-25%) combined BRAF- and MEK-inhibition indicated meaningful activity. Still, further effective therapeutic options are required for patients without identifiable driver mutations. The role of immunotherapy (IT) in this regard is an area of active interest. Recently, combined application of the multityrosine kinase inhibitor Lenvatinib and the PD1- inhibitor Pembrolizumab showed promising results in 6 ATC and 2 PDTC patients with detectable PD-L1 expression level (ATLEP) resulting in an implementation of a prospective trial (ATLEP II). An evaluation of 35 included patients (27 ATC, 8 PDTC) showed an ORR of 34.3% (12/35) with a median OS of 10.25 months in ATC patients. Here, we investigated real-word efficacy of an in-house cohort of Lenvatinib and Pembrolizumab treated poorly (PDTC) and anaplastic (ATC) thyroid cancer patients (ATC n =6, PDTC n =4) in a tertiary tumour centre. The objective response rate in ATC was 50% (3/6). Tree patients had partial response, and 3 patients had durable stable disease. The median overall survival since first application of IT was 10.5 months. The objective response rate in PDTC was 25% (1/4). The median overall survival since first IT administration was 20 months. Nine patients had tumour tissue available for PD-L1 expression testing and only in one sample, PD-L1 expression was < 10%. Four patients (4/10) experienced an immune-related adverse event (grade 3 or higher). To conclude, in line with previous data, IT may represent an effective treatment option for a subset of PDTC and ATC patients with manageable toxicity in a real-world setting.
Volume 92
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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