Behind a Real-World Study of Lenvatinib in RAI-Refractory DTC

Francis P. Worden, MD, professor of medicine at the University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, discusses a real-world study evaluating lenvatinib (Lenvima) for the treatment of patients with radioiodine (RAI)-refractory differentiated thyroid cancer (DTC).

He highlights that in the study, they discovered that patients with BRAF mutations did well when treated with lenvatinib. This suggests that lenvatinib could be a beneficial frontline treatment option for a wider range of patients with RAI-refractory DTC

Transcription:

0:09 | What we did is we looked at our real-world experience. We went ahead and did an analysis retrospectively of the patients who had BRAF V600E mutations, or other BRAF mutations, such as the K601E mutation, and then those who were not available for mutational status, so the mutational status was not identified. What we found is that, overwhelmingly, [patients] did well with these BRAF mutations when treated with lenvatinib.

0:56 | This is important because we believe that we should be considering lenvatinib upfront for patients who have these BRAF mutations. Those [with] BRAF mutations, you can see progression-free survival is around 56 months in survival rates that were not reached. That was also true for the wild-type and those that were essentially not tested.

1:35 | What this is telling us is that, again, based on the data that was published in our real-world experience, patients with BRAF mutations upfront should be treated with lenvatinib over, probably, a BRAF/MEK inhibitor.

1:58 | I will have to be honest, because if you look at the Kaplan-Meier curves that are listed on our poster, they pretty much overlap. But you have to be careful because the numbers are relatively small across the board. There are more of the BRAF V600E mutations as compared with the K601E mutations. Essentially, what our data shows is that across the board those were untested, those who have BRAF V600E and the K601E mutations relatively performed the same.

REFERENCE:

Worden FP, Wirth LJ, Reynolds N, et al. Patients with radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) with BRAF V600E and/or K601E mutation status: A real-world view of effectiveness of lenvatinib monotherapy. J Clin Oncol. 2024;42(suppl 16):6098. doi.org:10.1200/JCO.2024.42.16_suppl.6098