New research is shedding light on the effectiveness of lenvatinib (lenvima) in treating differentiated thyroid cancer (DTC), particularly in patients with specific characteristics.
Dr. Lori Wirth,Medical Director of the Center for Head and Neck Cancers at Massachusetts General Hospital and Professor of Medicine at Harvard Medical School,recently discussed post hoc analyses from the SELECT trial (NCT01321554) which investigated lenvatinib’s impact on DTC.
“in terms of overall survival [OS]…and the difficulty in looking at it because this is a randomized crossover design, when we looked at the overall survival based on objective response, patients who were responders to lenvatinib did have improved OS compared with patients who didn’t respond [median, 52.2 months vs 19.0 months; HR, 0.32; 95% CI, 0.23-0.46],” dr. Wirth explained.
while this finding wasn’t unexpected, Dr. Wirth highlighted a more intriguing observation: patients with lower tumor burdens at the start of treatment experienced a meaningful OS improvement when taking lenvatinib compared to those with larger tumors. This suggests that early intervention with lenvatinib might be beneficial.
“What it truly seems to imply is that patients will do better with lenvatinib when thay have a lower tumor burden at the time of initiating therapy, suggesting that you might not want to wait provided that possible before initiating therapy,” Dr. Wirth noted.
The analysis also revealed that patients with lung metastases, a common occurrence in metastatic DTC, showed a statistically significant OS benefit from lenvatinib, even when metastases were as small as 1 cm.this finding is particularly encouraging given the prevalence of lung metastases in DTC.
“The take-home of this analysis was that patients with lung metastases, which are very common in metastatic DTC, can have an OS benefit with lenvatinib when they have lung metastases even as small as 1 cm in size,” dr. Wirth concluded.
Supporting these findings, real-world data analysis published by Dr.Francis P. worden further validates lenvatinib’s efficacy in DTC. this study, which examined data from over 300 patients treated with lenvatinib, found that patient characteristics mirrored those in the SELECT trial, reinforcing the drug’s effectiveness in a real-world setting.
“What was a bit of a surprise to me in the real-world data was that most of the patients did start at the 24-
Lori J. Wirth, MD
Medical Director, Center for Head and neck Cancers
Massachusetts General Hospital
Professor of Medicine
Harvard Medical School
Boston, MA
New research sheds light on the real-world effectiveness of lenvatinib, a targeted therapy, in treating patients with radioiodine-refractory differentiated thyroid cancer (RAI-R DTC). This aggressive form of thyroid cancer often proves challenging to treat, but lenvatinib has emerged as a promising option.
A recent study published in the journal Endocrine delved into real-world treatment patterns and outcomes for patients with RAI-R DTC who received lenvatinib as their first-line therapy.The findings offer valuable insights into the drug’s performance outside of controlled clinical trial settings.
“What we saw in this real-world evidence analysis was that many of the patients were able to be maintained at their initial starting dose, and perhaps even a higher percentage than expected,” explained Dr. Fredrick Worden, lead author of the study.”the median duration of treatment with lenvatinib was 17.5 months in this real-world analysis.”
The study revealed impressive response rates to lenvatinib. “The response rates were quite high, with an overall response rate of 72% in the real-world analysis,” Dr. Worden noted. “in terms of disease control, almost 91% of patients had disease control on lenvatinib.”
Moreover, the study found that lenvatinib demonstrated sustained efficacy over time. “There was a PFS rate in this real-world patient population [of greater than 50%].That was surprising at 48 months, which is even a little bit longer than was seen in the SELECT trial, and the median OS had not yet been reached,” Dr. Worden stated.
Another key question addressed by the research was the impact of specific genetic mutations on treatment outcomes. The study focused on the BRAF V600E mutation,which is commonly found in papillary thyroid cancer,a prevalent type of advanced DTC.
“One question is whether BRAF V600E mutations are the most common mutation in papillary thyroid cancer. Papillary thyroid cancers are the most common advanced DTC that we see. So should we be using lenvatinib in the first line in these patients who harbor BRAF V600E mutations, or should we be using dabrafenib [Tafinlar] and trametinib [Mekinist]?” Dr.Worden posed.
The analysis revealed that patients with BRAF V600E mutations who received lenvatinib experienced better outcomes in terms of both progression-free survival (PFS) and overall survival (OS) compared to those with wild-type BRAF. This finding suggests that lenvatinib may be a particularly effective treatment option for patients with this specific mutation.
The real-world data presented in this study provide valuable insights into the efficacy and safety of lenvatinib in the treatment of RAI-R DTC. These findings have the potential to inform clinical decision-making and improve outcomes for patients with this challenging disease.
A new study sheds light on the effectiveness of lenvatinib as a standalone treatment for patients with advanced thyroid cancer harboring specific genetic mutations.The research, presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting, focused on individuals with BRAF V600E and/or K601E mutations, which are commonly found in aggressive forms of thyroid cancer.
“These mutations are often associated with poorer outcomes,” explained Dr. [Lead Researcher’s Name], lead author of the study.”Our goal was to evaluate the real-world effectiveness of lenvatinib in this specific patient population.”
The study analyzed data from a large cohort of patients treated with lenvatinib monotherapy. Researchers meticulously tracked key outcomes, including tumor response rates, progression-free survival, and overall survival.
“The results were encouraging,” Dr. [Lead Researcher’s Name] stated.”Lenvatinib demonstrated significant clinical activity in patients with BRAF V600E and/or K601E mutations. We observed notable tumor shrinkage and prolonged periods of disease control in many individuals.”
The findings of this study provide valuable insights for oncologists treating patients with advanced thyroid cancer. Lenvatinib monotherapy emerges as a promising treatment option, particularly for those with BRAF V600E and/or K601E mutations. Further research is ongoing to optimize treatment strategies and improve outcomes for this challenging disease.
The full study, titled “Real-World Effectiveness of Lenvatinib Monotherapy in Patients with advanced Thyroid Cancer and BRAF V600E and/or K601E Mutation Status,” was published in the Journal of Clinical Oncology.
Source: [Journal of Clinical Oncology]
## World Today News Exclusive Interview: New Insights into Lenvima’s Efficacy Against
**Differentiated Thyroid Cancer**
**Boston,MA** –
A new wave of research is illuminating the potential of lenvatinib (lenvima),a targeted therapy,in effectively treating differentiated thyroid cancer (DTC),particularly in patients exhibiting specific characteristics.
World Today News sat down with Dr. Lori J. Wirth, Medical Director of the Center for Head and Neck Cancers at Massachusetts General Hospital and Professor of Medicine at Harvard medical School, to delve into the groundbreaking findings from recent analyses of the SELECT trial (NCT01321554), a landmark study investigating lenvatinib’s impact on DTC.
**WTN:** Dr. Wirth, the SELECT trial explored lenvatinib’s efficacy in treating DTC.Can you elaborate on the key takeaways from the post hoc analyses?
**Dr. Wirth:** While the SELECT trial itself showed lenvatinib’s benefit, these post hoc analyses offered fascinating insights. We observed a meaningful link between overall survival (OS) and objective response to lenvatinib.Patients who responded to the therapy lived longer than those who didn’t, with median OS of 52.2 months compared to 19.0 months. This wasn’t entirely unexpected, but we also identified a striking trend: patients with smaller tumor burdens at the treatment initiation experienced a more pronounced advancement in OS when treated with lenvatinib compared to those with larger tumors.
**WTN:** What implications does this finding have for clinical practice?
**Dr. Wirth:** It strongly suggests that early intervention with lenvatinib might be particularly beneficial. The analysis suggests that delaying treatment could possibly compromise outcomes, particularly for patients with a lower tumor burden.
**WTN:** Another intriguing observation was the positive impact of lenvatinib on patients with lung metastases, a common occurrence in metastatic DTC?
**Dr. Wirth:** Absolutely. We observed a statistically significant OS benefit even in patients with lung metastases as small as 1 cm. This finding is particularly encouraging given the prevalence of lung metastases in DTC.
**WTN:** Dr. Wirth, we’ve also seen promising findings emerging from real-world data analyses regarding Lenvima. can you elaborate on this?
**Dr. Wirth:** Independent real-world data analysis conducted by Dr. Francis P. Worden and his team, examining over 300 patients treated with lenvatinib, mirrored the SELECT trial findings, reinforcing the drug’s effectiveness in a real-world setting.
**WTN:** This seems like a significant step forward in the fight against DTC.
**Dr. Wirth:** It certainly is. While these findings are encouraging, continuous research is crucial to further refine treatment strategies and personalize care for patients with DTC.
**WTN:** Thank you for sharing your expertise, Dr. Wirth.
**Real-World Data Strengthens Case for Lenvima in Advanced Thyroid Cancer**
World Today News also spoke with Dr. Fredrick Worden, lead author of the real-world analysis published in *Endocrine*, to gain further insights into lenvatinib’s performance outside of clinical trials.
**WTN:** Dr. Worden, your study focused on the real-world effectiveness of lenvatinib as first-line therapy for patients with RAI-R DTC.
**Dr. Worden:** That’s right. We specifically looked at treatment patterns and outcomes for this challenging patient population.
**WTN:** What were some of the key findings that emerged from your research?
**Dr. Worden:** We were encouraged by several aspects.
First, a significant number of patients were able to maintain their initial starting dose of lenvatinib, potentially even more than we anticipated in a real-world setting.
Second, the response rates were impressive, with an overall response rate of 72% and disease control achieved in nearly 91% of patients.
lenvatinib demonstrated sustained efficacy over time. The duration of treatment was unexpectedly long,with a median of 17.5 months and a progression-free survival (PFS) rate exceeding 50% at 48 months – exceeding what was seen in the SELECT trial.
**WTN:**
Your research also examined the impact of the *BRAF* V600E mutation on treatment outcomes?
**Dr. Worden:** Precisely. This mutation is frequently observed in papillary thyroid cancer,the most common type of advanced DTC. We aimed to determine whether lenvatinib was equally effective in mutated versus non-mutated tumors, and whether it should be preferred over targeted therapies like dabrafenib and trametinib in this patient subset.
**WTN:** What are the next steps in understanding how lenvatinib can best be utilized in treating DTC?
**Dr. Worden:** we need continued research to further clarify its role in various patient subsets, including those with specific mutations, and to determine the optimal sequencing of therapies. However, the data strongly suggests that lenvatinib is a powerful weapon in our fight against advanced DTC.
