PMID- 32814730
OWN - NLM
STAT- MEDLINE
DCOM- 20211014
LR  - 20220325
IS  - 1348-4540 (Electronic)
IS  - 0918-8959 (Linking)
VI  - 67
IP  - 12
DP  - 2020 Dec 28
TI  - Comparative efficacy and safety of tyrosine kinase inhibitors for thyroid cancer: 
      a systematic review and meta-analysis.
PG  - 1215-1226
LID - 10.1507/endocrj.EJ20-0171 [doi]
AB  - The tyrosine kinase inhibitors (TKIs) sorafenib, lenvatinib, vandetanib, and 
      cabozantinib are currently used for thyroid cancer treatment; however, the 
      differences in their clinical efficacy and toxicity remain unclear. This 
      meta-analysis assessed the efficacy and toxicity of these four TKIs based on 34 
      studies. The pooled incidence of partial response (PR), stable disease (SD), 
      TKI-related adverse events (AEs), and pooled median progression-free survival 
      (PFS) were calculated with 95% confidence intervals (CI). Complete response to 
      TKIs was extremely rare (0.3%). The highest PR rate and longest PFS were observed 
      for lenvatinib in differentiated thyroid cancer (69%, 95% CI: 57-81 and 19 
      months, 95% CI: 9-29, respectively) and vandetanib in medullary thyroid cancer 
      (40%, 95% CI: 25-56 and 31 months, 95% CI: 19-43, respectively). Although the 
      discontinuation rate due to AEs was similar for each TKI, there was a difference 
      in the most frequently observed AE for each TKI (hand-foot syndrome for 
      sorafenib, hypertension and proteinuria for lenvatinib, and QTc prolongation for 
      vandetanib). The identified differences in the TKI efficacy and AE profiles may 
      provide a better understanding of thyroid cancer treatment. Although TKIs are 
      promising agents for thyroid cancer treatment, they are unlikely to lead to a 
      cure. Thus, even in the TKI era, a multimodal treatment including surgery, 
      radioiodine therapy, external beam radiotherapy, and TKIs is required to optimize 
      patient chances of improved survival.
FAU - Oba, Takaaki
AU  - Oba T
AD  - Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu 
      University School of Medicine, Matsumoto 390-8621, Japan.
FAU - Chino, Tatsunori
AU  - Chino T
AD  - Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu 
      University School of Medicine, Matsumoto 390-8621, Japan.
FAU - Soma, Ai
AU  - Soma A
AD  - Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu 
      University School of Medicine, Matsumoto 390-8621, Japan.
FAU - Shimizu, Tadafumi
AU  - Shimizu T
AD  - Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu 
      University School of Medicine, Matsumoto 390-8621, Japan.
FAU - Ono, Mayu
AU  - Ono M
AD  - Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu 
      University School of Medicine, Matsumoto 390-8621, Japan.
FAU - Ito, Tokiko
AU  - Ito T
AD  - Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu 
      University School of Medicine, Matsumoto 390-8621, Japan.
FAU - Kanai, Toshiharu
AU  - Kanai T
AD  - Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu 
      University School of Medicine, Matsumoto 390-8621, Japan.
FAU - Maeno, Kazuma
AU  - Maeno K
AD  - Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu 
      University School of Medicine, Matsumoto 390-8621, Japan.
FAU - Ito, Ken-Ichi
AU  - Ito KI
AD  - Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu 
      University School of Medicine, Matsumoto 390-8621, Japan.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20200818
PL  - Japan
TA  - Endocr J
JT  - Endocrine journal
JID - 9313485
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Phenylurea Compounds)
RN  - 0 (Piperidines)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Quinazolines)
RN  - 0 (Quinolines)
RN  - 9ZOQ3TZI87 (Sorafenib)
RN  - EE083865G2 (lenvatinib)
RN  - YO460OQ37K (vandetanib)
SB  - IM
MH  - Antineoplastic Agents/adverse effects/*therapeutic use
MH  - Humans
MH  - Phenylurea Compounds/adverse effects/therapeutic use
MH  - Piperidines/adverse effects/therapeutic use
MH  - Protein Kinase Inhibitors/adverse effects/*therapeutic use
MH  - Quinazolines/adverse effects/therapeutic use
MH  - Quinolines/adverse effects/therapeutic use
MH  - Sorafenib/adverse effects/therapeutic use
MH  - Thyroid Neoplasms/*drug therapy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Adverse event
OT  - Meta-analysis
OT  - Thyroid cancer
OT  - Tyrosine kinase inhibitor
EDAT- 2020/08/21 06:00
MHDA- 2021/10/15 06:00
CRDT- 2020/08/21 06:00
PHST- 2020/08/21 06:00 [pubmed]
PHST- 2021/10/15 06:00 [medline]
PHST- 2020/08/21 06:00 [entrez]
AID - 10.1507/endocrj.EJ20-0171 [doi]
PST - ppublish
SO  - Endocr J. 2020 Dec 28;67(12):1215-1226. doi: 10.1507/endocrj.EJ20-0171. Epub 2020 
      Aug 18.