PMID- 35737285
OWN - NLM
STAT- MEDLINE
DCOM- 20220916
LR  - 20221023
IS  - 1559-0100 (Electronic)
IS  - 1355-008X (Linking)
VI  - 78
IP  - 1
DP  - 2022 Oct
TI  - Successful dose escalation of lenvatinib for thyroid cancer after disease 
      progression.
PG  - 77-84
LID - 10.1007/s12020-022-03117-5 [doi]
AB  - PURPOSE: Lenvatinib is started at a standard dose, continuing with dose reduction 
      and interruption, balancing between efficacy and adverse events (AEs). Because 
      few drugs are available for thyroid cancer, efforts for continuing treatment with 
      one agent, such as "dose escalation (DE)", are made. The dose is increased, 
      aiming to regain the anti-tumor effect after dose reduction. The effects of 
      lenvatinib DE in differentiated thyroid carcinoma (DTC) patients are reported. 
      PATIENTS AND METHODS: The efficacy of lenvatinib DE in DTC patients using the 
      serum thyroglobulin (Tg) level and management of AEs was investigated. RESULTS: A 
      total of 70 DE episodes in 33 patients were investigated. The median increased 
      dose was 2.0 (1.0-14.0) mg, increased from 8.6 (2-16) mg to 10.1 (6-24) mg. The 
      serum Tg level decreased in 53 DE episodes. Though the serum Tg level in 17 DE 
      episodes was not decreased, the Tg rate of increase was decreased in 7 of these 
      DE episodes using the Tg-doubling rate. Overall, clinical benefit was seen in 60 
      (86%) DE episodes. AEs that could not be controlled after DEs were seen in only 
      16% of cases. No intolerable AEs were observed in patients who received more drug 
      holidays at the time of DEs compared to two times before the DEs. CONCLUSION: DE 
      may become one of the standard treatment strategies after disease progression if 
      AEs are well managed. Drug holidays may be a key for successfully controlling AEs 
      with DE. DE can be useful for controlling progressive disease with increasing Tg 
      levels.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Masaki, Chie
AU  - Masaki C
AUID- ORCID: 0000-0002-5959-6182
AD  - Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, 
      Japan. c-masaki@ito-hospital.jp.
FAU - Sugino, Kiminori
AU  - Sugino K
AD  - Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, 
      Japan.
FAU - Akaishi, Junko
AU  - Akaishi J
AD  - Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, 
      Japan.
FAU - Hames, Kiyomi Y
AU  - Hames KY
AD  - Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, 
      Japan.
FAU - Tomoda, Chisato
AU  - Tomoda C
AD  - Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, 
      Japan.
FAU - Suzuki, Akifumi
AU  - Suzuki A
AD  - Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, 
      Japan.
FAU - Matsuzu, Kenichi
AU  - Matsuzu K
AD  - Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, 
      Japan.
FAU - Ohkuwa, Keiko
AU  - Ohkuwa K
AD  - Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, 
      Japan.
FAU - Kitagawa, Wataru
AU  - Kitagawa W
AD  - Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, 
      Japan.
FAU - Nagahama, Mitsuji
AU  - Nagahama M
AD  - Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, 
      Japan.
FAU - Ito, Koichi
AU  - Ito K
AD  - Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, 
      Japan.
LA  - eng
PT  - Journal Article
DEP - 20220623
PL  - United States
TA  - Endocrine
JT  - Endocrine
JID - 9434444
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Phenylurea Compounds)
RN  - 0 (Quinolines)
RN  - EE083865G2 (lenvatinib)
SB  - IM
MH  - *Adenocarcinoma/drug therapy
MH  - Antineoplastic Agents/administration & dosage/adverse effects
MH  - Disease Progression
MH  - Dose-Response Relationship, Drug
MH  - Humans
MH  - *Phenylurea Compounds/administration & dosage/adverse effects
MH  - *Quinolines/administration & dosage/adverse effects
MH  - *Thyroid Neoplasms/drug therapy/pathology
OTO - NOTNLM
OT  - Adverse events
OT  - Dose escalation
OT  - Dose intensity
OT  - Lenvatinib
OT  - Thyroglobulin-doubling rate
OT  - Thyroid carcinoma
EDAT- 2022/06/24 06:00
MHDA- 2022/09/17 06:00
CRDT- 2022/06/23 11:22
PHST- 2022/03/07 00:00 [received]
PHST- 2022/06/14 00:00 [accepted]
PHST- 2022/06/24 06:00 [pubmed]
PHST- 2022/09/17 06:00 [medline]
PHST- 2022/06/23 11:22 [entrez]
AID - 10.1007/s12020-022-03117-5 [pii]
AID - 10.1007/s12020-022-03117-5 [doi]
PST - ppublish
SO  - Endocrine. 2022 Oct;78(1):77-84. doi: 10.1007/s12020-022-03117-5. Epub 2022 Jun 
      23.