Sorafenib in RAI-Resistant Differentiated Thyroid Cancer

Marcia Brose, MD, PhD, discusses the rationale, background, and results from the phase III DECISION study that explored sorafenib in radioactive iodine-resistant differentiated thyroid cancer.

Marcia Brose, MD, PhD, an assistant professor of otolaryngology and head and neck surgery in the Abramson Cancer Center and the Perelman School of Medicine at the University of Pennsylvania, discusses the rationale, background, and results from the phase III DECISION study that explored sorafenib in radioactive iodine-resistant differentiated thyroid cancer (DTC).

Clinical Pearls

Overall, 70% of DTCs are associated with kinase related gene mutations. Kinase inhibitors have made a major difference for patients in other cancers types, providing the rationale to explore them further in DTC. In this study, 417 patients with RAI-resistant metastatic DTC were randomized to sorafenib, a tyrosine kinase inhibitor or placebo. The median progression-free survival with sorafenib was 10.8 months compared to 5.8 months in the placebo arm.

  • 70% of DTCs are associated with kinase related gene mutations, providing the rationale to explore a TKI in this space
  • The phase III DECISION study explored sorafenib in RAI-resistant DTC
  • In the study, the median PFS with sorafenib was 10.8 months compared to 5.8 months in the placebo arm