Benekli Mustafa, Yalcin Suayib, Ozkan Metin, Elkiran Emin Tamer, Sevinc Alper, Cabuk Devrim, Coskun Hasan Senol, Oksuzoglu Berna, Bayar Banu, Akbulat Akif, Ozet Ahmet
Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.
Department of Medical Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Onco Targets Ther. 2014 Dec 15;8:1-5. doi: 10.2147/OTT.S70670. eCollection 2015.
Antivascular endothelial growth factor tyrosine kinase inhibitors have been used recently in the treatment of advanced differentiated thyroid cancer (DTC) and medullary thyroid cancer (MTC). Off-label sorafenib is used in Turkey with special permission by the Ministry of Health for this indication.
Patients with advanced DTC and MTC were retrospectively identified from the Turkish Ministry of Health database. Data on these patients were prospectively collected before permission is granted to use sorafenib.
Thirty patients with complete data were analyzed: 14 DTC (papillary number [n] =10; follicular n=4) and 16 MTC. The median age of the patients was 57 years (range: 28-79 years), and there were 18 males and 12 females. All DTC patients were iodine refractory and had received a median three doses of radioactive iodine (range: 1-7 doses). Sorafenib was used for a median of 12 months (range: 1-49 months). The overall response rate was 20%, all partial responses, with no complete response. The overall response rate was 14% in DTC and 25% in MTC patients. The median progression-free survival (PFS) was 17.1 months (95% confidence interval [CI]: 7.3-26.8) and overall survival (OS) was not reached. The 2-year PFS and OS were 39% and 68%, respectively. DTC and MTC patients had similar survival outcomes: median PFS of 21.3 months (95% CI: 5.8-36.7) versus 14.5 months (95% CI: 3.7-25.2), respectively (P=0.36), with the median OS not reached in either group (P=0.17). Tumor marker levels did not have any prognostic or predictive role. The toxicity profile was similar to that of other sorafenib trials.
Sorafenib is an effective and well-tolerated treatment in advanced thyroid cancers.
抗血管内皮生长因子酪氨酸激酶抑制剂最近已用于治疗晚期分化型甲状腺癌（DTC）和甲状腺髓样癌（MTC）。在土耳其，索拉非尼在获得卫生部特别许可后用于该适应症。
从土耳其卫生部数据库中回顾性识别出晚期DTC和MTC患者。在获得使用索拉非尼的许可之前，前瞻性收集这些患者的数据。
对30例有完整数据的患者进行了分析：14例DTC（乳头状癌n = 10；滤泡状癌n = 4）和16例MTC。患者的中位年龄为57岁（范围：28 - 79岁），男性18例，女性12例。所有DTC患者均对碘难治，且接受放射性碘的中位剂量为3剂（范围：1 - 7剂）。索拉非尼的中位使用时间为12个月（范围：1 - 49个月）。总缓解率为20%，均为部分缓解，无完全缓解。DTC患者的总缓解率为14%，MTC患者为25%。中位无进展生存期（PFS）为17.1个月（95%置信区间[CI]：7.3 - 26.8），总生存期（OS）未达到。2年PFS和OS分别为39%和68%。DTC和MTC患者的生存结果相似：中位PFS分别为21.3个月（95% CI：5.8 - 36.7）和14.5个月（95% CI：3.7 - 25.2）（P = 0.36），两组的中位OS均未达到（P = 0.17）。肿瘤标志物水平没有任何预后或预测作用。毒性特征与其他索拉非尼试验相似。
索拉非尼是晚期甲状腺癌的一种有效且耐受性良好的治疗方法。
