Dose Escalation of Lenvatinib effective for Differentiated Thyroid Carcinoma, study finds

Dose escalation of Lenvatinib has successfully been used to treat Differentiated Thyroid carcinoma (DTC) based on a study that was published in the journal, Endocrine.

Dose Escalation (DE) is a process where the dose of the drug is increased to reach the anti-tumor effect after dose reduction. This is done when there are few drugs available for treatment and when treatment is continued with one agent. Lenvatinib is started at a standard dose for the treatment of thyroid cancer and by balancing between efficacy and the adverse events, dose reduction or dose interruption is done.

Masaki et al from Ito hospital, Japan conducted a study to check the efficacy of Lenvatinib DE in DTC patients using the serum thyroglobulin (Tg) level. They also investigated the management of adverse events.

Results:

• In the study, 70 DE episodes in 33 patients were investigated.
• The median increased dose was 2.0 (1.0–14.0) mg, increased from 8.6 (2–16) mg to 10.1 (6–24) mg.
• In 53 DE episodes, serum Tg level was decreased.
• Serum Tg level in 17 DE episodes was not decreased, the Tg rate of increase was decreased in 7 of these DE episodes using the Tg-doubling rate.
• In 60 (86%) DE episodes, clinical benefit was seen.
• In 16% of cases, AEs that could not be controlled after DEs were seen.
• In patients who received more drug holidays at the time of DEs, no intolerable AEs were observed compared to two times before the DEs.

Thus, the researchers concluded that, in the case of properly managed AEs, DE may become one of the standard treatment strategies after disease progression. With increasing Tg levels, DE can be useful for controlling the progressive disease. They further added that for successful control of AEs with DE, drug holidays may be the key for management.  

For the full article, click here: https://doi.org/10.1007/s12020-022-03117-5