Dr. Marcia Brose Discusses Lenvatinib as a New Option in DTC

Marcia S. Brose, MD, PhD, associate professor of Otorhinolaryngology: Head and Neck Surgery at the Hospital of the University of Pennsylvania, discusses lenvatinib (Lenvima) as a new treatment option for patients with radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC).

On February 13, 2015, the FDA approved lenvatinib, based on findings from the phase III SELECT trial. Treatment with the multikinase inhibitor lenvatinib resulted in a median progression-free survival of 18.3 months compared with 3.6 months with placebo (HR = 0.21; P <.0001).

It is likely that lenvatinib will be administered in both the second- and first-line setting, Brose notes. For newly diagnosed patients with RAI-refractory DTC, lenvatinib will likely be used as a frontline therapy. However, in patients who have already received sorafenib or another TKI, lenvatinib is an effective second-line therapy, Brose explains.

With sorafenib, hand-foot syndrome should be managed closely and patients should be advised on how to best manage this side effect. However, with lenvatinib, hand-foot syndrome is not the major side effect. With this TKI, hypertension and weight loss are the main adverse events that require close monitoring. Additionally, diarrhea and blood clots should be addressed, Brose notes.