Lenvatinib: an investigational agent for the treatment of differentiated thyroid cancer.

Abstract

INTRODUCTION:

Differentiated thyroid cancer (DTC; >90% of all TCs) derives from follicular cells. Surgery is the main therapeutic strategy, and radioiodine (RAI) is administered after thyroidectomy. When DTC progresses, it does not respond to RAI and thyroid-stimulating hormone (TSH)-suppressive thyroid hormone treatment, and other therapies (i.e. surgery, external beam radiation therapy and chemotherapy) do not lead to a better survival. Thanks to the understanding of the molecular pathways involved in TC progression, important advances have been done. Lenvatinib is a multitargeted tyrosine kinase inhibitor of VEGFR1-3, FGFR1-4, PDGFRα, RET, and KIT signaling networks implicated in tumor angiogenesis, approved in locally recurrent or metastatic, progressive, RAI-refractory DTC. Unmet needs regarding the patient clinical therapy responsiveness in aggressive RAI-refractory DTC still remain.

AREAS COVERED:

We provide an overview from the literature of in vitro, in vivo and real-life studies regarding lenvatinib as an investigational agent for the treatment of aggressive TC.

EXPERT OPINION:

According to the SELECT trial, the treatment should be initiated with a dosage of 24 mg/day, subsequently decreasing it in relation to the side effects. The decision making process in patients with aggressive RAI-refractory DTC should be personalized and the potential toxicity should be properly managed.

• Authors: Silvia Martina Ferrari, Giusy Elia, Francesca Ragusa, Sabrina Rosaria Paparo, Valeria Mazzi, Mario Miccoli, Maria Rosaria Galdiero, Gilda Varricchi, Rudy Foddis, Giovanni Guglielmi, Claudio Spinelli, Concettina La Motta, Salvatore Benvenga, Alessandro Antonelli, Poupak Fallahi
• Journal: Expert opinion on investigational drugs (Expert Opin Investig Drugs) Vol. 30 Issue 9 Pg. 913-921 (Sep 2021) ISSN: 1744-7658 [Electronic] England
• PMID: 34428101 (Publication Type: Journal Article, Review)

Chemical References

• Antineoplastic Agents
• Drugs, Investigational
• Phenylurea Compounds
• Protein Kinase Inhibitors
• Quinolines
• lenvatinib

Topics

• Antineoplastic Agents (administration & dosage, pharmacology)
• Combined Modality Therapy
• Disease Progression
• Drugs, Investigational (administration & dosage, pharmacology)
• Humans
• Phenylurea Compounds (administration & dosage, pharmacology)
• Protein Kinase Inhibitors (administration & dosage, pharmacology)
• Quinolines (administration & dosage, pharmacology)
• Thyroid Neoplasms (drug therapy, pathology)
• Thyroidectomy