Lenvatinib Plus High-Dose Radioiodine Therapy Shows Promise for Patients With Metastatic Well-Differentiated Thyroid Cancer
The use of high-dose radioiodine therapy (HDRI) in combination with lenvatinib, showed potential for treatment of patients with radioiodine-avid metastatic well-differentiated thyroid cancer.
This study enrolled 15 patients with well-differentiated thyroid cancer, regardless of prior exposure to HDRI. Patients received lenvatinib for 3 months with thyroxine suppression. Thyroxine was then withdrawn and patients underwent whole-body radioiodine scan and HDRI. Response was evaluated by imaging and tumor tumor markers.
There were 10 patients with a partial response and 4 with stable disease, based on imaging and tumor marker levels. There was 1 patient who progressed, according to thyroglobulin measurement and imaging. Serum thyroglobulin levels fell from a median of 7094.0 ng/ml to a median of 1796.0 ng/ml, and this fall was not associated with age, sex, histopathology, or previous exposure to HDRI. There were 2/3 of patients who experienced a grade 1 toxicity. There was 1 death, due to pneumonia, in follow-up that was not cancer related.
Study authors noted that the fall in tumor marker level and the partial response on imagining from a single cycle of therapy was “unprecedented.” While this study has a small sample sizes, the study authors stated “preliminary data suggest that the synergistic effect may improve data control” and concluded, “Further investigation with a larger cohort is warranted to confirm findings and explore potential response predictors.”
Source:
Sharma S, Nazar AH, Mishra P, et al. A new therapeutic paradigm: Radioiodine combined with lenvatinib for radioiodine-avid metastatic well-differentiated thyroid cancer. Nuclear Medicine Communications. Published online: April 1, 2025. doi:10.1097/MNM.0000000000001980
