Clinical efficacy of lenvatinib for the treatment of radioiodine‐refractory thyroid carcinoma: A systematic review and meta‐analysis of clinical trials

Objective To evaluate the efficacy of lenvatinib in the treatment of radioiodine‐refractory thyroid carcinoma. Background Thyroid carcinoma is one of the top ten carcinomas worldwide. Clinically, thyroid cancers are managed with resections and adjuvant therapy with radioiodine. However, radioiodine...

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Bibliographic Details
Published in:Clinical endocrinology (Oxford) 2021-09, Vol.95 (3), p.478-488
Main Authors: Yan, Zhipeng, Yang, Ming, Lai, Ching‐Lung
Format: Article
Language:English
Subjects:
Adverse events
Antineoplastic Agents - therapeutic use
Clinical trials
Enzyme inhibitors
Humans
Iodine Radioisotopes - therapeutic use
lenvatinib
Meta-analysis
Middle Aged
Original
Patients
Phenylurea Compounds - therapeutic use
Placebos
Quinolines - therapeutic use
Survival
systematic review
Thyroid cancer
Thyroid carcinoma
Thyroid Neoplasms - drug therapy
Treatment Outcome
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Summary:Objective To evaluate the efficacy of lenvatinib in the treatment of radioiodine‐refractory thyroid carcinoma. Background Thyroid carcinoma is one of the top ten carcinomas worldwide. Clinically, thyroid cancers are managed with resections and adjuvant therapy with radioiodine. However, radioiodine is not effective for radioiodine‐refractory (RR) thyroid carcinoma in some patients. Lenvatinib is a multi‐kinase inhibitor for the treatment of RR thyroid carcinoma. Several clinical trials showed its efficacy in prolonging progression‐free survival (PFS) and overall survival (OS). Design, patients and measurements A systematic search was done on databases (PubMed, Embase, MEDLINE, Cochrane) on 8 June 2020. Search keywords were lenvatinib, thyroid carcinoma and randomized controlled trials. Clinical trials fulfilling the SELECT protocol were selected to evaluate the efficacy of lenvatinib in terms of prolongation of PFS, OS and objective response rate (ORR). The risk ratio and distribution of grade 3 or above adverse events were documented. Results Of the 3997 patients of mean age 62.5 years in fifteen selected studies, lenvatinib is associated with prolonged PFS (hazard ratio 0.24, 95% CI, 0.19‐0.31, p 
ISSN:0300-0664
1365-2265
DOI:10.1111/cen.14479