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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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| Published in: | Clinical endocrinology (Oxford) 2021-09, Vol.95 (3), p.478-488 |
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| container_title | Clinical endocrinology (Oxford) |
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| creator | Yan, Zhipeng Yang, Ming Lai, Ching‐Lung |
| description | 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 |
| doi_str_mv | 10.1111/cen.14479 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8453970</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2511239742</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4439-33fe36b1f471de41f213cba32ee616755144d553abd5e1a2989640f931962f8c3</originalsourceid><addsrcrecordid>eNp1kc1u1DAURi0EokNhwQsgS2xgkdb_SVggVaMWkCrYwNpynGvqKrGL7ZkqOx6BPW_Hk9TDtBUgkc1d3JOjz_dD6DklR7R-xxbCERWi7R-gFeVKNowp-RCtCCekIUqJA_Qk50tCiOxI-xgdcN5xIalYoZ_ryQdvzYTBuTrtgqPDE4StKXUxYBcTLheASwJTZghlt09m9NHH0Qf49f1HApeMLTEtlVxS9CO2Jlkf4mze4BOcl1xgrj6LE2w9XGMTRjxDMfVnE8y0ZJ93WnuXpSRvpvwUPXJ1wLPbeYi-nJ1-Xr9vzj-9-7A-OW-sELxvOHfA1UCdaOkIgjpGuR0MZwCKqlbWd4pRSm6GUQI1rO96JYjrOe0Vc53lh-jt3nu1GWYY6zVLMpO-Sn42adHReP33JvgL_TVudSck71tSBa9uBSl-20AuevbZwjSZAHGTNZOUskoKVtGX_6CXcZPqDXaUEm1tq-OVer2nbIo51_veh6FE7yrXNYr-XXllX_yZ_p6867gCx3vg2k-w_N-k16cf98ob5zW64w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2564706683</pqid></control><display><type>article</type><title>Clinical efficacy of lenvatinib for the treatment of radioiodine‐refractory thyroid carcinoma: A systematic review and meta‐analysis of clinical trials</title><source>Wiley</source><creator>Yan, Zhipeng ; Yang, Ming ; Lai, Ching‐Lung</creator><creatorcontrib>Yan, Zhipeng ; Yang, Ming ; Lai, Ching‐Lung</creatorcontrib><description>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 < .001) and OS (hazard ratio 0.65, 95% CI, 0.52‐0.81, p < .001). Compared with placebo, the risk ratio of ORR and incidence of grade 3 or above adverse events are 35.41 (95% CI, 19.42‐64.58, p < .001) and 8.25 (95% CI, 6.50‐10.46, p < .001), respectively. Subgroup analysis shows that lenvatinib is effective for all patients with RR thyroid carcinoma, regardless of age, histological subtypes, radiological subtypes and mutation status.
Conclusion
Lenvatinib is effective in the treatment of RR thyroid carcinoma. Close monitoring of serious adverse events is recommended.</description><identifier>ISSN: 0300-0664</identifier><identifier>EISSN: 1365-2265</identifier><identifier>DOI: 10.1111/cen.14479</identifier><identifier>PMID: 33834514</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>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</subject><ispartof>Clinical endocrinology (Oxford), 2021-09, Vol.95 (3), p.478-488</ispartof><rights>2021 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2021 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4439-33fe36b1f471de41f213cba32ee616755144d553abd5e1a2989640f931962f8c3</citedby><cites>FETCH-LOGICAL-c4439-33fe36b1f471de41f213cba32ee616755144d553abd5e1a2989640f931962f8c3</cites><orcidid>0000-0003-1939-2772</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33834514$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yan, Zhipeng</creatorcontrib><creatorcontrib>Yang, Ming</creatorcontrib><creatorcontrib>Lai, Ching‐Lung</creatorcontrib><title>Clinical efficacy of lenvatinib for the treatment of radioiodine‐refractory thyroid carcinoma: A systematic review and meta‐analysis of clinical trials</title><title>Clinical endocrinology (Oxford)</title><addtitle>Clin Endocrinol (Oxf)</addtitle><description>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 < .001) and OS (hazard ratio 0.65, 95% CI, 0.52‐0.81, p < .001). Compared with placebo, the risk ratio of ORR and incidence of grade 3 or above adverse events are 35.41 (95% CI, 19.42‐64.58, p < .001) and 8.25 (95% CI, 6.50‐10.46, p < .001), respectively. Subgroup analysis shows that lenvatinib is effective for all patients with RR thyroid carcinoma, regardless of age, histological subtypes, radiological subtypes and mutation status.
Conclusion
Lenvatinib is effective in the treatment of RR thyroid carcinoma. Close monitoring of serious adverse events is recommended.</description><subject>Adverse events</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Clinical trials</subject><subject>Enzyme inhibitors</subject><subject>Humans</subject><subject>Iodine Radioisotopes - therapeutic use</subject><subject>lenvatinib</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Patients</subject><subject>Phenylurea Compounds - therapeutic use</subject><subject>Placebos</subject><subject>Quinolines - therapeutic use</subject><subject>Survival</subject><subject>systematic review</subject><subject>Thyroid cancer</subject><subject>Thyroid carcinoma</subject><subject>Thyroid Neoplasms - drug therapy</subject><subject>Treatment Outcome</subject><issn>0300-0664</issn><issn>1365-2265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kc1u1DAURi0EokNhwQsgS2xgkdb_SVggVaMWkCrYwNpynGvqKrGL7ZkqOx6BPW_Hk9TDtBUgkc1d3JOjz_dD6DklR7R-xxbCERWi7R-gFeVKNowp-RCtCCekIUqJA_Qk50tCiOxI-xgdcN5xIalYoZ_ryQdvzYTBuTrtgqPDE4StKXUxYBcTLheASwJTZghlt09m9NHH0Qf49f1HApeMLTEtlVxS9CO2Jlkf4mze4BOcl1xgrj6LE2w9XGMTRjxDMfVnE8y0ZJ93WnuXpSRvpvwUPXJ1wLPbeYi-nJ1-Xr9vzj-9-7A-OW-sELxvOHfA1UCdaOkIgjpGuR0MZwCKqlbWd4pRSm6GUQI1rO96JYjrOe0Vc53lh-jt3nu1GWYY6zVLMpO-Sn42adHReP33JvgL_TVudSck71tSBa9uBSl-20AuevbZwjSZAHGTNZOUskoKVtGX_6CXcZPqDXaUEm1tq-OVer2nbIo51_veh6FE7yrXNYr-XXllX_yZ_p6867gCx3vg2k-w_N-k16cf98ob5zW64w</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Yan, Zhipeng</creator><creator>Yang, Ming</creator><creator>Lai, Ching‐Lung</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1939-2772</orcidid></search><sort><creationdate>202109</creationdate><title>Clinical efficacy of lenvatinib for the treatment of radioiodine‐refractory thyroid carcinoma: A systematic review and meta‐analysis of clinical trials</title><author>Yan, Zhipeng ; Yang, Ming ; Lai, Ching‐Lung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4439-33fe36b1f471de41f213cba32ee616755144d553abd5e1a2989640f931962f8c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adverse events</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Clinical trials</topic><topic>Enzyme inhibitors</topic><topic>Humans</topic><topic>Iodine Radioisotopes - therapeutic use</topic><topic>lenvatinib</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Patients</topic><topic>Phenylurea Compounds - therapeutic use</topic><topic>Placebos</topic><topic>Quinolines - therapeutic use</topic><topic>Survival</topic><topic>systematic review</topic><topic>Thyroid cancer</topic><topic>Thyroid carcinoma</topic><topic>Thyroid Neoplasms - drug therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yan, Zhipeng</creatorcontrib><creatorcontrib>Yang, Ming</creatorcontrib><creatorcontrib>Lai, Ching‐Lung</creatorcontrib><collection>Wiley Open Access</collection><collection>Wiley Free Archive</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical endocrinology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yan, Zhipeng</au><au>Yang, Ming</au><au>Lai, Ching‐Lung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical efficacy of lenvatinib for the treatment of radioiodine‐refractory thyroid carcinoma: A systematic review and meta‐analysis of clinical trials</atitle><jtitle>Clinical endocrinology (Oxford)</jtitle><addtitle>Clin Endocrinol (Oxf)</addtitle><date>2021-09</date><risdate>2021</risdate><volume>95</volume><issue>3</issue><spage>478</spage><epage>488</epage><pages>478-488</pages><issn>0300-0664</issn><eissn>1365-2265</eissn><abstract>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 < .001) and OS (hazard ratio 0.65, 95% CI, 0.52‐0.81, p < .001). Compared with placebo, the risk ratio of ORR and incidence of grade 3 or above adverse events are 35.41 (95% CI, 19.42‐64.58, p < .001) and 8.25 (95% CI, 6.50‐10.46, p < .001), respectively. Subgroup analysis shows that lenvatinib is effective for all patients with RR thyroid carcinoma, regardless of age, histological subtypes, radiological subtypes and mutation status.
Conclusion
Lenvatinib is effective in the treatment of RR thyroid carcinoma. Close monitoring of serious adverse events is recommended.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33834514</pmid><doi>10.1111/cen.14479</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-1939-2772</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical endocrinology (Oxford), 2021-09, Vol.95 (3), p.478-488 |
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| language | eng |
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| source | Wiley |
| 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 |
| title | Clinical efficacy of lenvatinib for the treatment of radioiodine‐refractory thyroid carcinoma: A systematic review and meta‐analysis of clinical trials |
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