PMID- 38447630 OWN - NLM STAT- Publisher LR - 20240401 IS - 1530-891X (Print) IS - 1530-891X (Linking) DP - 2024 Mar 4 TI - Early Structural, Biochemical, and Metabolic Responses to Anlotinib in Patients With Progressive Radioactive Iodine Refractory Differentiated Thyroid Cancer. LID - S1530-891X(24)00077-6 [pii] LID - 10.1016/j.eprac.2024.02.005 [doi] AB - OBJECTIVE: We aimed to assess the early efficacy of anlotinib in patients with progressive radioactive iodine refractory differentiated thyroid cancer at the structural, biochemical, and metabolic levels. METHODS: Ten eligible patients were prospectively enrolled to receive anlotinib. Their responses were assessed at 6 weeks. Apart from the structural response according to Response Evaluation Criteria in Solid Tumors version 1.1, the biochemical response was assessed by serum thyroglobulin (Tg), and the metabolic response was assessed by 2-deoxy-2-[18F] fluoro-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) according to the European Organization for Research and Treatment of Cancer criteria. A safety profile was recorded. RESULTS: Structurally controlled disease (20% partial response + 80% stable disease) was observed in all patients. The median longest diameter of target lesions shrank from 20.8 mm (IQR, 14.9-27.5) to 17.0 mm (IQR, 14.1-23.7) (P < .001), and the average shrinkage rate was -15.1 +/- 14.1%. Sharp serum Tg reduction by 72.8 +/- 16.4% was observed in 8 measurable patients. The (18)F-FDG PET/CT-mapped glucose metabolic response was not quite comparable to the structural response, with 90% of the patients having controlled disease (30% partial metabolic response + 60% stable metabolic disease), whereas 10% presented progressive metabolic disease. The most common treatment-emergent adverse events (AEs) were hypertension (100%) and proteinuria (70%). Most AEs were grade 1 or 2, whereas grade 3 AEs occurred only in hypertension. CONCLUSION: Anlotinib is generally well tolerated and can bring early disease control within the initial 6 weeks of treatment. The sharp biochemical response suggests Tg to be an early sensitive biomarker to anlotinib, whereas the heterogeneous metabolic response might play a complementary role. CI - Copyright (c) 2024 AACE. Published by Elsevier Inc. All rights reserved. FAU - Sun, Di AU - Sun D AD - Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing 100730, China; Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China. FAU - Zhang, Xin AU - Zhang X AD - Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing 100730, China; Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China. FAU - Sun, Yuqing AU - Sun Y AD - Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing 100730, China; Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China. FAU - Mu, Zhuanzhuan AU - Mu Z AD - Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing 100730, China; Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China. FAU - Wang, Hao AU - Wang H AD - Department of Oncology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao 266012, China. FAU - Zhang, Yingqiang AU - Zhang Y AD - Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing 100730, China; Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China. FAU - Liang, Jun AU - Liang J AD - Department of Oncology, Peking University International Hospital, Peking University, Beijing 102206, China; Department of Medical Oncology, Key Laboratory of Carcinogenesis & Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing 100142, China. Electronic address: liangjun1959@aliyun.com. FAU - Lin, Yansong AU - Lin Y AD - Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing 100730, China; Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China. Electronic address: linys@pumch.cn. LA - eng PT - Journal Article DEP - 20240304 PL - United States TA - Endocr Pract JT - Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists JID - 9607439 SB - IM OTO - NOTNLM OT - (18)F-FDG-PET/CT OT - anlotinib OT - early response OT - multikinase inhibitor OT - radioactive iodine refractory differentiated thyroid cancer COIS- Disclosure The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/03/07 00:43 MHDA- 2024/03/07 00:43 CRDT- 2024/03/06 19:13 PHST- 2023/10/15 00:00 [received] PHST- 2024/02/22 00:00 [revised] PHST- 2024/02/28 00:00 [accepted] PHST- 2024/03/07 00:43 [pubmed] PHST- 2024/03/07 00:43 [medline] PHST- 2024/03/06 19:13 [entrez] AID - S1530-891X(24)00077-6 [pii] AID - 10.1016/j.eprac.2024.02.005 [doi] PST - aheadofprint SO - Endocr Pract. 2024 Mar 4:S1530-891X(24)00077-6. doi: 10.1016/j.eprac.2024.02.005.