The Role of Lenvatinib in Differentiated Thyroid Cancer Treatment

Warren Swegal, MD, a head and neck cancer surgeon at Allegheny Health Network, explains how lenvatinib (Lenvima) in currently used in the differentiated thyroid cancer landscape.

According to Swegal, the use of lenvatinib in this patient population is supported by findings from the SELECT trial (NCT01321554) of lenvatinib vs placebo in patients with iodine-131-refractory disease. Overall, the study showed a significant improvement in progression-free survival with lenvatinib over placebo. The median PFS observed was 18.3 months vs 3.6 months (HR, 0.21; 99% CI, 0.14-0.31; P <.001), according to published study results.

Swegal explains the ongoing studies are exploring lenvatinib further. For example, some studies are taking a retrospective look at the data around lenvatinib to see if the survival data are consistent. Thus far, Swegal says the PFS is similar when assessed prospectively and retrospectively.

TRANSCRIPT:

0:08 | As of right now for those patients that are radioactive iodine refractory and have differentiated thyroid cancer and have systemic disease, lenvatinib is the kind of preferred or category-1 level of evidence recommended by the NCCN. This is kind of the tool in the bag for a lot of medical oncologist, you know.

0:32 | A lot of that is based on the recent trials, specifically the SELECT trial, which was done a couple of years ago, which is a phase 3 trial placebo controlled, where they compare the lenvatinib to patients receiving placebo. It showed that, you know, for younger patients, patients had better progression-free survival and for older patients even better overall survival compared with placebo. Now, follow up studies to that looking at kind of retrospective use of the drug have showed a similar somewhat variable progression-free survival compared to that.

_REFERENCE:

_{Schlumberger M, Tahara M, Wirth LJ, et al. Lenvatinib versus placebo in radioiodine-refractory thyroid cancer. N Engl J Med. 2015; 372:621-630. doi: 10.1056/NEJMoa1406470}