Exploring the Potential of Lenvatinib Combos in Thyroid Cancer


Lori J. Wirth, MD, associate professor of medicine at Harvard Medical School and medical director of the Center for Head and Neck Cancers at Massachusetts General Hospital, explains how investigators continue to push the field of thyroid cancer forward following the phase 3 SELECT trial of lenvatinib (Lenvima).


0:09 | One of the things that's been a challenge in the field is that in the SELECT trial, we saw that lenvatinib really works so well. It has been difficult to design trials with new approaches that could perform better than lenvatinib. So I guess it is a good problem to have, but nonetheless, we always want to be moving the field forward.

0:33 | There has been interest in the combination of lenvatinib plus pembrolizumab [Keytruda] in patients with thyroid cancer. There was a small multicenter, 2 arm, international Florida Oncology Group trial that was performed investigating lenvatinib plus pembrolizumab in 2 different patient cohorts. One in previously untreated patients with iodine-refractory, progressing, differentiated thyroid cancer, and then the second cohort was in patients that were already on lenvatinib who progressed, and at the time of progression, then pembrolizumab was added, and the lenvatinib was continued.

1:16 | That study has not yet been published, but it has been presented in abstract form at a couple of meetings, and it does look like there is some promise with activity. But again, [it is] very difficult to know whether we could see even better outcomes with lenvatinib/pembrolizumab compared with lenvatinib alone in the previously untreated patient population.

1:43 | One thing that I will say about that combination that is also of interest is that lenvatinib plus pembrolizumab is being studied in more aggressive thyroid cancers, namely anaplastic thyroid cancer and poorly differentiated thyroid cancer, in a study being conducted in Germany, and then also here in the United States. The preliminary data that had been presented from the German study have looked very intriguing.

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