Matsuo Mioko, Ito Mamoru, Tsuchihashi Kenji, Ohmura Hirofumi, Hashimoto Kazuki, Kogo Ryunosuke, Sato Masanobu, Masuda Shogo, Nakagawa Takashi
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;
Department of Hematology, Oncology and Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
In Vivo. 2025 Sep-Oct;39(5):2854-2861. doi: 10.21873/invivo.14085.
BACKGROUND/AIM: Refractory differentiated thyroid carcinoma (DTC) and anaplastic thyroid carcinoma (ATC) are associated with poor prognoses. Molecularly targeted agents such as lenvatinib are expected to significantly improve outcomes. However, data from real-world settings remain limited.
A retrospective analysis was conducted in 48 patients with thyroid carcinoma treated with lenvatinib at Kyushu University Hospital between April 2015 and October 2024. We compared overall survival (from time of treatment initiation to death, censoring, or data cutoff) and progression-free survival (from time of treatment initiation to tumor progression as confirmed by image examination) using Kaplan-Meier analysis. A subgroup analysis was also conducted for patients who had and had not received prior radioactive iodine (RAI) therapy.
The analysis included 29 female and 19 male cases. The histologic types were papillary thyroid carcinoma in 26 patients, follicular thyroid carcinoma in seven patients, and ATC in 15 patients. Of 33 DTC cases, RAI was not administered in nine cases. The median progression-free survival was 30 months for papillary thyroid carcinoma, 18 months for follicular thyroid carcinoma, and four months for ATC. The median progression-free survival for patients with DTC who received RAI therapy was 19 months, whereas that for patients with DTC without RAI therapy was 46 months. No significant difference was found between the two groups (=0.243).
Lenvatinib may be effective in patients with DTC in whom RAI treatment is not feasible in real-world settings.
背景/目的：难治性分化型甲状腺癌（DTC）和未分化甲状腺癌（ATC）的预后较差。乐伐替尼等分子靶向药物有望显著改善治疗效果。然而，真实世界的数据仍然有限。
对2015年4月至2024年10月在九州大学医院接受乐伐替尼治疗的48例甲状腺癌患者进行回顾性分析。我们使用Kaplan-Meier分析比较了总生存期（从治疗开始至死亡、 censoring或数据截止）和无进展生存期（从治疗开始至经影像检查确认的肿瘤进展）。还对接受和未接受过放射性碘（RAI）治疗的患者进行了亚组分析。
分析包括29例女性和19例男性病例。组织学类型为乳头状甲状腺癌26例，滤泡状甲状腺癌7例，ATC 15例。在33例DTC病例中，9例未接受RAI治疗。乳头状甲状腺癌的中位无进展生存期为30个月，滤泡状甲状腺癌为18个月，ATC为4个月。接受RAI治疗的DTC患者的中位无进展生存期为19个月，而未接受RAI治疗的DTC患者为46个月。两组之间未发现显著差异（=0.243）。
在真实世界中，对于无法进行RAI治疗的DTC患者，乐伐替尼可能有效。
