PMID- 31244783
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200225
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 10
DP  - 2019
TI  - Safety of Tyrosine Kinase Inhibitors in Patients With Differentiated Thyroid 
      Cancer: Real-World Use of Lenvatinib and Sorafenib in Korea.
PG  - 384
LID - 10.3389/fendo.2019.00384 [doi]
LID - 384
AB  - Background: Thyroid cancer has become the most common cancer in Korea. Generally, 
      thyroid cancer patients have a good prognosis; however, 15-20% of patients 
      experience recurrence or distant metastasis or are refractory to standard 
      treatment. We assessed the safety of sorafenib and lenvatinib in patients with 
      advanced or metastatic radioactive iodine-refractory differentiated thyroid 
      cancers (DTC) consecutively treated at a tertiary center in South Korea. Methods: 
      We retrospectively reviewed the charts of all consecutive patients with DTC 
      treated during >/=6 months with lenvatinib (February 2016-April 2018) and sorafenib 
      (January 2014-April 2018) at Gangnam Severance Hospital. Patients were treated 
      according to the prescribing information of each drug and were followed up for 2 
      months. We evaluated the adverse events (AEs) reported with each drug. Results: A 
      total of 71 medical records (lenvatinib, n = 23; sorafenib, n = 48) were 
      reviewed. The most common histological types were papillary thyroid cancer 
      (69.0%) and follicular thyroid cancer (22.5%). All patients (n = 23) started 
      lenvatinib at a dose of 20 mg; 41.7% of sorafenib-treated patients received an 
      initial dose of 800 mg daily. Four (17.4%) lenvatinib-treated patients and 26 
      (54.2%) sorafenib-treated patients required treatment discontinuation. The most 
      common AEs of any grade in the lenvatinib group were diarrhea (82.6%), 
      hypertension (78.3%), hand-foot skin reaction (56.5%), weight loss (52.2%), 
      proteinuria (47.8%), and anorexia (43.5%). In the sorafenib group, these were 
      hand-foot skin reaction (87.5%), diarrhea (62.5%), anorexia (60.4%), alopecia 
      (56.3%), mucositis (52.1%), weight loss and generalized weakness (each, 50%), and 
      hypertension (43.8%). The incidence of hand-foot skin reaction, alopecia, and 
      rash of any grade was significantly lower (P = 0.003, P = 0.017, and P = 0.017) 
      in patients treated with lenvatinib compared with those treated with sorafenib. 
      The incidence of hypertension, QT prolongation, and proteinuria of any grade was 
      significantly higher (P = 0.006, P = 0.038, and P < 0.001) in patients treated 
      with lenvatinib compared with those treated with sorafenib. Seven deaths 
      occurred, which were attributed to disease progression. Conclusions: No new 
      safety concerns were identified for either drug. Most AEs were managed with dose 
      modification and medical therapy. AEs such as hypertension and proteinuria 
      warrant close monitoring.
FAU - Kim, Soo Young
AU  - Kim SY
AD  - Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei 
      University College of Medicine, Seoul, South Korea.
FAU - Kim, Seok-Mo
AU  - Kim SM
AD  - Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei 
      University College of Medicine, Seoul, South Korea.
FAU - Chang, Hojin
AU  - Chang H
AD  - Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei 
      University College of Medicine, Seoul, South Korea.
FAU - Kim, Bup-Woo
AU  - Kim BW
AD  - Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei 
      University College of Medicine, Seoul, South Korea.
FAU - Lee, Yong Sang
AU  - Lee YS
AD  - Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei 
      University College of Medicine, Seoul, South Korea.
FAU - Chang, Hang-Seok
AU  - Chang HS
AD  - Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei 
      University College of Medicine, Seoul, South Korea.
FAU - Park, Cheong Soo
AU  - Park CS
AD  - Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei 
      University College of Medicine, Seoul, South Korea.
LA  - eng
PT  - Journal Article
DEP - 20190612
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
PMC - PMC6581694
OTO - NOTNLM
OT  - adverse effects
OT  - chart review
OT  - differentiated thyroid cancer
OT  - lenvatinib
OT  - refractory thyroid cancer
OT  - safety
OT  - sorafenib
OT  - tyrosine kinase inhibitors
EDAT- 2019/06/28 06:00
MHDA- 2019/06/28 06:01
PMCR- 2019/01/01
CRDT- 2019/06/28 06:00
PHST- 2019/01/24 00:00 [received]
PHST- 2019/05/28 00:00 [accepted]
PHST- 2019/06/28 06:00 [entrez]
PHST- 2019/06/28 06:00 [pubmed]
PHST- 2019/06/28 06:01 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2019.00384 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2019 Jun 12;10:384. doi: 10.3389/fendo.2019.00384. 
      eCollection 2019.