Predictors of response to lenvatinib in advanced differentiated thyroid cancer: focus on the CONUT score.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2025-04-11 DOI:10.1007/s12020-025-04228-5

Edoardo Talpacci, Silvia Morelli, Vincenzo Leone, Sonia Moretti, Miriam Paci, Vittorio Bini, Efisio Puxeddu

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引用次数: 0

Abstract

Objective: Lenvatinib is a multityrosine kinase inhibitor approved for progressive radioiodine refractory differentiated thyroid cancer (RAI-R-DTC). Despite its efficacy, most of the initial experiences showed global inferior results if compared with SELECT study. Baseline disease stages, previous systemic treatments and baseline patients' characteristics may affect response to therapy. The aim of our study was to review relevant clinical outcomes, identifying survival predictors, of a single center cohort of patients with advanced thyroid cancer treated with Lenvatinib.

Methods: Twenty-two patients with progressive RAIR-R-DTC treated with Lenvatinib were retrospectively included. For each patient, we reviewed the main clinical baseline characteristics, including nutritional status. We evaluated the latter by using CONtrolling NUTritional status (CONUT) score. Clinical outcomes were overall survival (OS) and progression free survival (PFS).

Results: At the time of analysis, 14 patients (63.6%) were alive with a median OS of 54 months (95% CI 20.35-87.65 months). Progression occurred in 16 patients (72.7%) with a median PFS of 21 months (95% CI 0-47.33 months). Nineteen out of 22 patients (86.4%) presented at least one adverse event (AE) of any grade. Baseline lower CONUT score significantly correlated with both longer PFS (HR 2.77- 95% CI 1.216-6.307, p = 0.015) and longer OS (HR 4.455-95% CI 1.211-16.391, p = 0.025). A significant longer survival was observed in patients with ECOG 0 compared to those with ECOG 1 and in the latter compared to ECOG 2 group (Log-rank test: p = 0.040). Conversely, higher baseline ECOG Performance Status (PS) correlated with higher severity of AEs (rs 0.468, p = 0.027). Finally, responder patients showed a significantly better PFS (HR 2.337-95% CI 1.091-5.006, p = 0.029).

Conclusion: We confirmed the good efficacy of Lenvatinib treatment in progressive advanced RAI-R-DTCs showing the prognostic value of best tumor response, ECOG PS and CONUT score.

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lenvatinib治疗晚期分化型甲状腺癌疗效的预测因素：关注CONUT评分。

目的：Lenvatinib是一种多酪氨酸激酶抑制剂，被批准用于治疗进展性放射性碘难治性分化甲状腺癌（RAI-R-DTC）。尽管其有效性，但与SELECT研究相比，大多数初始经验显示整体结果较差。基线疾病分期、既往全身治疗和基线患者特征可能影响对治疗的反应。本研究的目的是回顾Lenvatinib治疗的晚期甲状腺癌单中心队列患者的相关临床结果，确定生存预测因素。方法：回顾性分析22例接受Lenvatinib治疗的进展性RAIR-R-DTC患者。对于每位患者，我们回顾了主要的临床基线特征，包括营养状况。我们用控制营养状态（CONUT）评分来评估后者。临床结果为总生存期（OS）和无进展生存期（PFS）。结果：在分析时，14例患者（63.6%）存活，中位OS为54个月（95% CI 20.35-87.65个月）。16名患者（72.7%）出现进展，中位PFS为21个月（95% CI 0-47.33个月）。22例患者中有19例（86.4%）出现至少一次任何级别的不良事件（AE）。基线较低的CONUT评分与较长的PFS （HR 2.77- 95% CI 1.216-6.307, p = 0.015）和较长的OS （HR 4.455-95% CI 1.211-16.391, p = 0.025）显著相关。ECOG 0组患者的生存期明显长于ECOG 1组，ECOG 1组患者的生存期明显长于ECOG 2组（Log-rank检验：p = 0.040）。相反，较高的基线ECOG性能状态（PS）与较高的ae严重程度相关（rs 0.468, p = 0.027）。最后，有反应的患者表现出明显更好的PFS （HR 2.337-95% CI 1.091-5.006, p = 0.029）。结论：Lenvatinib治疗进展性晚期rar - r - dtc疗效良好，具有最佳肿瘤反应、ECOG PS和CONUT评分的预后价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.