SEARCHGUIDELINESoncology, endocrinology

guidelines·oncology, endocrinology, internal medicine, clinical nutrition·PMC10448584

Use of lenvatinib in the treatment of radioiodine-refractory differentiated thyroid cancer: a multidisciplinary perspective for daily practice

European Thyroid Journal · 12 authors, 13 centres

AI SUMMARY

FIDELITY 100%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

“

TL;DR

The central result is a consensus-based practical framework covering patient selection, treatment initiation, monitoring, and adverse event management to support treatment adherence and outcomes.

Full summary

956 CHARS

This publication is a multidisciplinary expert guidance document based on the shared clinical experience and consensus of a panel of ten European experts. It provides practical recommendations for managing patients with radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) treated with lenvatinib. The document addresses patient selection, initiation of therapy, follow-up monitoring, and management of adverse events. Key management strategies are detailed, including for common adverse events like hypertension, diarrhea, and fatigue, with suggested interventions and thresholds for dose modification. A central limitation is that the guidance is derived from expert opinion and clinical experience, not from new clinical trial data. The document stresses the importance of multidisciplinary assessment and patient engagement. It concludes that lenvatinib is expected to remain a first-line treatment for RAI-R DTC for the foreseeable future.

STUDY TYPE

guidelines

SPECIALTY

oncology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10448584

Use of lenvatinib in the treatment of radioiodine-refractory differentiated thyroid cancer: a multidisciplinary perspective for daily practice

European Thyroid Journal

READ THE FULL PAPER

ABSTRACT

Abstract Background Most thyroid cancers of follicular origin have a favorable outcome. Only a small percentage of patients will develop metastatic disease, some of which will become radioiodine refractory (RAI-R). Important challenges to ensure the best therapeutic outcomes include proper, timely, and appropriate diagnosis; decisions on local, systemic treatments; management of side effects of therapies; and a good relationship between the specialist, patients, and caregivers. Methods With the aim of providing suggestions that can be useful in everyday practice, a multidisciplinary group of experts organized the following document, based on their shared clinical experience with patients with RAI-R differentiated thyroid cancer (DTC) undergoing treatment with lenvatinib. The main areas covered are patient selection, initiation of therapy, follow-up, and management of adverse events. Conclusions It is essential to provide guidance for the management of RAI-R DTC patients with systemic therapies, and especially lenvatinib, since compliance and adherence to treatment are fundamental to achieve the best outcomes. While the therapeutic landscape in RAI-R DTC is evolving, with new targeted therapies, immunotherapy, etc., lenvatinib is expected to remain a first-line treatment and mainstay of therapy for several years in the vast majority of patients and settings. The guidance herein covers baseline work-up and initiation of systemic therapy, relevance of symptoms, multidisciplinary assessment, and patient education. Practical information based on expert experience is also given for the starting dose of lenvatinib, follow-up and monitoring, as well as the management of adverse events and discontinuation and reinitiating of therapy. The importance of patient engagement is also stressed. Keywords: differentiated thyroid cancer, lenvatinib, radioiodine refractory, toxicity, management

CITATION EXPORT

Jaume Capdevila, Desiree’ Deandreis, Cosimo Durante et al.. Use of lenvatinib in the treatment of radioiodine-refractory differentiated thyroid cancer: a multidisciplinary perspective for daily practice. European Thyroid Journal. (2023). https://doi.org/10.1530/ETJ-23-0068

AUTHORS

12 · 13 CENTRES

Jaume Capdevila, Desiree’ Deandreis, Cosimo Durante, Sophie Leboulleux, Markus Luster, Romana Netea-Maier, Kate Newbold, Susanne Singer, Gerasimos P Sykiotis, Beate Bartes, Kate Farnell, Laura Deborah Locati

1Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), IOB Quiron-Teknon, Barcelona, Spain
2Department of Medical Sciences, Nuclear Medicine Unit, University of Turin, AOU Città della Salute e della Scienza, Turin, Italy
3Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
4Service of Endocrinology, Diabetology, University Hospital Geneve, Geneve, Switzerland
5Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany
6Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands
7Royal Marsden Hospital, London, United Kingdom
8Institute of Medical Biostatistics Epidemiology and Informatics (IMBEI), University Medical Center of Johannes Gutenberg University, Mainz, Germany
9Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
10Association “Vivre sans Thyroïde”, Léguevin, France
11Butterfly Thyroid Cancer Trust, Rowlands Gill, Tyne & Wear, UK
12Medical Oncology Unit, IRCCS ICS Maugeri, Pavia, Italy
13Department of Internal Medicine and Therapeutics, University of Pavia, Italy