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Lenvatinib proves
effective across tumour
burdens in differentiated
cancer of the thyroid
L
envatinib has been proven effective across tumour
burdens in a phase III trial in differentiated
thyroid cancer.
This finding was based on the baseline characteristics
of responders vs nonresponders from the Study of
(E7080) Lenvatinib in differentiated Cancer of the
Thyroid (SELECT).
Christoph W. Reuter, MD, of Hannover Medical
School, Germany, explained that in SELECT, lenvatinib
improved progression-free survival in patients with
differentiated thyroid cancer vs placebo (18.3 vs 3.6
months, hazard ratio 0.21, 99% confidence interval
0.14–0.31, P < 0.0001). Dr Reuter reported on the
change in the sum of target lesion diameter in patients
from SELECT who did and did not respond to
lenvatinib.
Patients were randomised 2:1 to lenvatinib 24 mg daily
or placebo. Tumours were assessed by independent
radiologic review every 8 weeks during randomisation
and by investigator review every 12 weeks during
the extension phase. Response was defined as the
demonstration of either a partial or complete response.
All other outcomes were categorised as nonresponse.
Of 261 lenvatinib-treated patients, 169 were
responders and 92 nonresponders. Among responders,
66% were age
≤
65 years and 46% were male. Forty-
eight percent of nonresponders were age
≤
65 years
and 51% were male.
Responders showed lower tumour burden than
nonresponders. Among responders, 33% had baseline
tumour burden
≤
35 mm and 67% were Eastern
Cooperative Oncology Group performance status 0.
Among nonresponders, 10% had baseline tumour
burden
≤
35 mm and 34% were Eastern Cooperative
Oncology Group performance status 0.
The median duration of treatment was longer in
responders than in nonresponders (14 [range 1.1–
26.8] months vs 5.5 [range 0.2–21.5] months). Median
baseline sum of target lesion diameters was 51.8 mm
(range 15.1–181.2) among responders, and median
maximum percent change from baseline was –52%
(range –100% to –30%). Among nonresponders, median
baseline sum of target lesion diameters was 71.5 mm
(range 15.9–331.2) and median maximum percent
change from baseline was –20% (range –38% to 66%).
Dr Reuter concluded that lenvatinib was effective across
tumour burdens in SELECT. In this analysis, the per-
centage of responders with lower tumour burden was
higher than in nonresponders. The data suggest that
earlier use of lenvatinib could be beneficial in patients
with differentiated cancer of the thyroid.
PracticeUpdate Editorial Team
Bevacizumab + irinotecan shows
promise in recurrent glioblastoma
T
he combination of bevacizumab and irinotecan has been shown to be poten-
tially beneficial in recurrent glioblastoma multiforme, report results of a
retrospective analysis of experience at a single institution.
Charlotte Besson, MD, of the Centre Paul Strauss, Strasbourg, France, explained
that in the absence of standard treatment for recurrent glioblastoma in Europe,
numerous prospective and retrospective studies have evaluated the combination
of bevacizumab + irinotecan. Dr Besson and colleagues reported on their centre’s
experience with this off-label combination.
Dr Besson and coinvestigators analysed consecutive patients treated initially by
the Stupp protocol and secondly with bevacizumab for glioblastoma between 2007
and 2013. Times to progression and overall survival, as well as toxicities, were
investigated.
Eighty-two patients were eligible for analysis. Median age at diagnosis was 59 years
(range 25–80) and median World Health Organisation performance status at recur-
rence was 1.23 (range 0–3). Sixty patients (73%) experienced toxicities related to
bevacizumab. These were mainly grades 1 and 2 (92%), such as hypertension, pro-
teinuria, haemorrhage, thrombosis, nausea, diarrhoea, fatigue, and neutropenia of
grades 3 (n=9) and 4 (n=1).
Estimates of Kaplan-Meier median progression-free and overall survival at recur-
rence, calculated from the start of bevacizumab + irinotecan, were 6.5 (95% CI
7.8) and 10.7 months (95% CI interval 8.5–12.5), respectively.
These were close to results of other prospective and retrospective studies, but were
observed in older patients than those trials (median age ranged from 44.7–57 years
in previous studies).
Median overall survival calculated from diagnosis was 23 months (95% CI 20.5–
24.9). Multivariate analysis showed that O6-methylguanine-DNA methyltransferase
status (methylated vs unmethylated) exerted no effect on progression-free survival
before the first recurrence.
Similarly, neither age (
≥
70 years vs <70 years) nor World Health Organisation per-
formance status exerted a significant influence on overall survival. This suggested
that this combination might be applicable to some frail patients. On the other hand,
new surgery of recurrent glioblastoma (n=18) improved survival at recurrence sig-
nificantly (P = 0.029).
Dr Besson concluded that the combination of bevacizumab + irinotecan was well
tolerated and may offer clinical benefit in patients with recurrent glioblastoma.
Moreover, surgery at recurrence was suggested to be associated with prolonged sur-
vival. The results are in line with previous studies and strengthen the role of these
agents for recurrent glioblastoma.
PracticeUpdate Editorial Team
© ECCO2017 European Cancer Congress
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