Department of Oncology, University Military Hospital Sainte-Anne, 2, Boulevard Sainte Anne, BP 600, 83000 Toulon, France.
Department of Head and Neck Surgery, University Military Hospital Sainte-Anne, 2, Boulevard Sainte Anne, BP 600, 83000 Toulon, France.
Curr Oncol. 2022 Oct 14;29(10):7718-7731. doi: 10.3390/curroncol29100610.
Anaplastic thyroid carcinoma (ATC) are highly aggressive malignant tumors with poor overall prognosis despite multimodal therapy. As ATC are extremely rare, no randomized controlled study has been published for metastatic disease. Thyrosine kinase inhibitors, especially lenvatinib and immune checkpoint inhibitors such as pembrolizumab, are emerging drugs for ATC. Few studies have reported the efficacity of pembrolizumab and lenvatinib association, resulting in its frequent off-label use. In this review, we discuss rationale efficacy and safety evidence for the association of lenvatinib and pembrolizumab in ATC. First, we discuss preclinical rationale for pembrolizumab monotherapy, lenvatinib monotherapy and synergistic action of pembrolizumab and lenvatinib in the metastatic setting. We also discuss clinical evidence for immunotherapy and pembrolizumab in ATC through the analysis of studies evaluating immunotherapy, lenvatinib and pembrolizumab lenvatinib association in ATC. In addition, we discuss the safety of this association and potential predictive biomarkers of efficiency.
间变性甲状腺癌（ATC）是一种高度侵袭性的恶性肿瘤，尽管采用了多种治疗方法，但总体预后仍较差。由于 ATC 极为罕见，因此没有针对转移性疾病的随机对照研究。酪氨酸激酶抑制剂，特别是仑伐替尼和免疫检查点抑制剂如 pembrolizumab，是治疗 ATC 的新兴药物。很少有研究报告 pembrolizumab 和 lenvatinib 联合使用的疗效，因此其经常被超适应证使用。在这篇综述中，我们讨论了 lenvatinib 和 pembrolizumab 联合治疗 ATC 的理论疗效和安全性证据。首先，我们讨论了 pembrolizumab 单药治疗、lenvatinib 单药治疗以及 pembrolizumab 和 lenvatinib 联合治疗在转移性疾病中的协同作用的临床前理论依据。我们还通过分析评估免疫疗法、ATC 中的 lenvatinib 和 pembrolizumab 以及 ATC 中 lenvatinib 和 pembrolizumab 联合治疗的研究，讨论了免疫疗法和 pembrolizumab 在 ATC 中的临床证据。此外，我们还讨论了这种联合治疗的安全性和潜在的疗效预测生物标志物。
