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Successful treatment switch from lenvatinib to sorafenib in a patient with radioactive iodine-refractory differentiated thyroid cancer intolerant to lenvatinib due to severe proteinuria
- Source :
- Auris Nasus Larynx. 45(6):1249-1252
- Publication Year :
- 2018
- Publisher :
- Elsevier B.V., 2018.
-
Abstract
- Sorafenib and lenvatinib showed efficacy for patients with radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC) in pivotal phase 3 clinical trials. Although the efficacy of lenvatinib in patients who received previous treatment with multi-target kinase inhibitors (m-TKIs), including sorafenib, was reported, the efficacy of sorafenib in patients who previously received lenvatinib remains unknown. A 75-year-old woman diagnosed as RAI-refractory poorly differentiated carcinoma with multiple lung metastases and started treatment with lenvatinib. She continued to receive lenvatinib but with repeated dose interruptions and reductions due to continuous proteinuria. Because of severe and persistent proteinuria as well as newly developed renal impairment, lenvatinib was suspended after two years of treatment. After the 7-month suspension, her proteinuria and renal impairment were partially improved, but her lung metastases progressed. Because she was unable to tolerate previous treatment with lenvatinib, sorafenib was started. At 7 months of treatment with sorafenib, her lung metastases shrank and she could continue sorafenib without exacerbation of proteinuria or renal impairment. This case may suggest that sorafenib does not exacerbate the proteinuria or renal impairment induced by lenvatinib, and may be an effective treatment option for RAI-refractory DTC patients who are unable to tolerate lenvatinib.
- Subjects :
- Oncology
Sorafenib
medicine.medical_specialty
Lung Neoplasms
Exacerbation
030209 endocrinology & metabolism
Antineoplastic Agents
urologic and male genital diseases
Radiation Tolerance
Radioactive iodine-refractory differentiated thyroid cancer
Iodine Radioisotopes
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Refractory
Internal medicine
medicine
Humans
Lenvatinib
Thyroid Neoplasms
Renal impairment
Thyroid cancer
Aged
Proteinuria
Lung
business.industry
Drug Substitution
Phenylurea Compounds
General Medicine
medicine.disease
female genital diseases and pregnancy complications
Clinical trial
medicine.anatomical_structure
Treatment Outcome
Otorhinolaryngology
chemistry
Thyroid Cancer, Papillary
030220 oncology & carcinogenesis
Quinolines
Surgery
Female
medicine.symptom
business
Tomography, X-Ray Computed
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 03858146
- Volume :
- 45
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Auris Nasus Larynx
- Accession number :
- edsair.doi.dedup.....0290953627d0a52415a87070048141c6