Survival Outcomes of Advanced Thyroid Cancer Enriched in Brain Metastases Following Treatment With Small Molecule Inhibitors.
brain metastasis
papillary thyroid cancer
survival outcomes
thyroid cancer
tyrosine kinase inhibitors
Journal
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
ISSN: 1530-891X
Titre abrégé: Endocr Pract
Pays: United States
ID NLM: 9607439
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
30
04
2023
revised:
19
07
2023
accepted:
11
08
2023
medline:
7
11
2023
pubmed:
20
8
2023
entrez:
19
8
2023
Statut:
ppublish
Résumé
Small molecule inhibitors (SMIs) are targeted therapies increasingly used in advanced thyroid carcinomas. This study aimed to evaluate the survival outcomes of thyroid cancer on SMI treatment, including in patients with brain metastases. This retrospective study included patients with thyroid carcinomas who received at least one SMI between 2008 and 2022 at a tertiary level, academic institution. SMI included lenvatinib, sorafenib, dabrafenib-trametinib, selpercatinib, and cabozantinib. Patients were grouped by the presence of brain metastasis. Kaplan-Meier and log-rank tests modeled the overall survival (OS), defined from detection of first metastasis. In total, 116 patients (49.1% female, median age 61.1 years [IQR, 51.1-71.0]) were included. Thyroid cancer subtypes were: 57 (49.6%) papillary, 23 (19.8%) anaplastic, 23 (19.8%) medullary, and 13 (11.2%) follicular. There were 18 (15.5%) patients with brain metastases, and 98 (84.5%) with visceral metastases. Age, sex, thyroid subtype, SMI, and time to recurrence were not different between cohorts. OS was shorter in the brain metastasis cohort (31.7 vs 42.2 months, P =.44) and was not different after excluding anaplastic thyroid cancer (29.1 vs 62.3 months, P =.21). In the case of papillary thyroid cancer, patients with brain metastases trended toward worse OS (22.0 vs 59.9 months, P =.13). Nonanaplastic histology, total thyroidectomy (OR, 40.0; P <.001), number of unique therapies (OR, 10.9; P =.047), and mutation-directed therapy (OR, 24.7; P =.003) were associated with improved OS. This single-institutional analysis reports survival outcomes of 116 patients with advanced thyroid cancer on targeted therapies, including 18 patients with brain metastases. Mutation-directed therapy for BRAF
Identifiants
pubmed: 37597577
pii: S1530-891X(23)00524-4
doi: 10.1016/j.eprac.2023.08.003
pii:
doi:
Substances chimiques
Proto-Oncogene Proteins B-raf
EC 2.7.11.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
881-889Informations de copyright
Copyright © 2023 AACE. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure E.Y. serves in the advisory board for Astellas Pharma. S. A. K. received research support from Merck, Bristol-Myers Squibb, and Castle Biosciences, consulted for Merck, Regeneron, and Castle Biosciences, and received honoraria from UpToDate. J. L. G. received institutional funding from Merck, Alkermes, Debio, Regeneron, and Genentech and consulted or served in the advisory boards for Regeneron, Merck, and Exelixis. The other authors have no multiplicity of interest to disclose.