A medical oncologist reviews real-world data on older patients with RAI-refractory DTC and provides her thoughts on treating this patient population.
Case: A 64-Year-Old Woman with DTC
Initial presentation
Clinical workup and initial treatment
Subsequent treatment and follow-up
This is a video synopsis/summary of a Case-Based Peer Perspective featuring: Lori Wirth, MD.
Wirth discusses real-world treatment patterns and clinical outcomes in older patients with radioactive iodine (RAI)–refractory differentiated thyroid cancer (DTC) treated with lenvatinib. A recent abstract presented at the American Thyroid Association 2023 meeting by the University of Michigan group reported on over 100 patients 65 years and older who were mostly treated with first-line lenvatinib. The median treatment duration was 17 months, and the median progression-free survival (PFS) had not been reached. The 12-month and 48-month median PFS rates were 75% and 52%, respectively, suggesting good activity and tolerability of lenvatinib in this older population.
These real-world findings mirror the data from the SELECT trial, where a subset analysis of patients 65 years and older showed an overall survival benefit in the randomized phase 3 trial. Wirth emphasizes that older age alone should not preclude treatment with lenvatinib, as these patients can benefit from therapy when they have RAI-refractory DTC. However, she notes that caution is needed due to the higher prevalence of comorbidities, particularly hypertension, and frailty in the older population. Close monitoring is essential as patients begin therapy, but older patients can be treated with VEGFR multikinase inhibitors such as lenvatinib.
Video synopsis is AI-generated and reviewed by Targeted Oncology® editorial staff.
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