Efficacy of sorafenib and impact on cardiac function in patients with thyroid cancer: a retrospective analysis.

Abstract

PURPOSE:

Sorafenib has recently been recognized as an important standard option for the management of patients with differentiated thyroid cancer. Although data concerning cardiac safety are available in pan-tumor studies, no data are available on its use in everyday clinical practice in patients with thyroid cancer.

METHODS:

In the off-label program of our institution, we enrolled 14 patients with different histological types of thyroid cancer suitable for treatment with sorafenib. Our aims were to evaluate cardiac safety factors-LVEF (left ventricular ejection fraction), heart rate and blood pressure-the cardiac markers NT-proBNP and troponin I, radiological response evaluated by CT and (18)FDG-PET (according to RECIST 1.1 criteria) and biomarker reduction (Eastern Cooperative Oncology Group Performance Status: ECOG PS) 0-2.

RESULTS:

Patients with ECOG PS 2 accounted for 36%. After starting sorafenib, many patients displayed reduced or stabilized metabolic activity in target lesions (clinical benefit = 44%), radiologic reduction or stabilization (74%) and decreased cancer markers (90%). Lung metastases displayed the largest reductions in size. Median overall survival (OS) was 7 months and median progression-free survival (PFS) was 3 months. No sign of cardiotoxicity was observed in almost all patients. LVEF was altered in two patients and proved symptomatic in one.

CONCLUSIONS:

Sorafenib seems to be effective in reducing disease progression in the early stages of treatment (3-6 months). Responses varied considerably according to the criteria investigated. Cardiac toxicities did not raise concerns and were in line with data reported in other malignancies. However, cardiac monitoring is recommended.

• Authors: L Mortara, G Pera, E Monti, S Morbelli, F Minuto, G Sambuceti, M Giusti
• Journal: Journal of endocrinological investigation (J Endocrinol Invest) Vol. 37 Issue 11 Pg. 1099-108 (Nov 2014) ISSN: 1720-8386 [Electronic] Italy
• PMID: 25283887 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents
• Biomarkers, Tumor
• Phenylurea Compounds
• Niacinamide
• Sorafenib

Topics

• Aged
• Aged, 80 and over
• Antineoplastic Agents (pharmacology, therapeutic use)
• Biomarkers, Tumor (blood)
• Electrocardiography (drug effects)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Niacinamide (analogs & derivatives, pharmacology, therapeutic use)
• Phenylurea Compounds (pharmacology, therapeutic use)
• Retrospective Studies
• Sorafenib
• Stroke Volume (physiology)
• Thyroid Neoplasms (blood, diagnosis, drug therapy)
• Treatment Outcome