Analysis of therapeutic response onset time in thyroid cancer patients treated by lenvatinib - Analysis of therapeutic response onset time in thyroid cancer patients treated by lenvatinib

Start Date01 Oct 2015

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ITO Hospital

100 Clinical Results associated with ITO Hospital

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01 Dec 2025·Cancer Chemotherapy and Pharmacology

Predictive factors for first dose reduction and interruption of lenvatinib after beginning of the standard dose in Japanese patients with thyroid cancer

Article

Author: Suzuki, Akifumi ; Fujita, Kazuma ; Ito, Koichi ; Nagahama, Mitsuji ; Miura, Masatomo ; Masaki, Chie ; Sugino, Kiminori

PURPOSEThe associations between first dose reduction or interruption by side effects and lenvatinib plasma trough concentration (C₀) after administration of a starting dose of 24 mg in 70 Japanese patients with thyroid cancer were evaluated.METHODSPlasma samples were collected each week for 1 month and at the first incidence of side effects leading to dose reduction or interruption after beginning administration of 24 mg lenvatinib.RESULTSThe area under the receiver operating characteristic curve was 0.789 at a lenvatinib C₀ threshold of 128.25 ng/mL for predicting the first dose reduction or interruption. The median time to the first dose reduction or interruption was 14.0 days in patients with a C₀ of ≥ 128.25 ng/mL and 21.0 days in those with a C₀ of < 128.25 ng/mL (P = 0.001). At one, two, three and four weeks respectively, the first dose reduction or interruption was associated with body weight (P = 0.034); sex (P = 0.021); sex, age, and lenvatinib C₀ of ≥ 128.25 ng/mL (P = 0.025, 0.024, and 0.048, respectively); and age and lenvatinib C₀ of ≥ 128.25 ng/mL (each P = 0.004).CONCLUSIONSOn day 8 after administration of 24 mg lenvatinib, lenvatinib dose may be adjusted based on the target C₀ of 128.25 ng/mL to maintain a high dose intensity during this early phase; however, because persistence of a higher C₀ of 128.25 ng/mL causes early dose interruption or reduction, prospective dose reduction based on the next lower target C₀ for the maintenance phase may be necessary.

04 Apr 2025·Endocrine Oncology

Clinical characteristics and prognosis of histological subtypes of papillary thyroid carcinoma in pediatric patients

Article

Author: Kitagawa, Wataru ; Masaki, Chie ; Yoshioka, Kana ; Inoue, Kosuke ; Akaishi, Junko ; Okamura, Ritsuko ; Katoh, Ryohei ; Hames, Kiyomi Y ; Matsuzu, Kenichi ; Suzuki, Akifumi ; Sugino, Kiminori ; Tomoda, Chisato ; Kondo, Tetsuo ; Ito, Koichi ; Saito, Yoshiyuki

The purpose of this study was to clarify the clinicopathological features and prognosis of histological subtypes of papillary thyroid carcinoma (PTC) in the pediatric population treated at a single institution. A total of 153 PTC patients ≤18 years of age who underwent initial surgery between 1979 and 2019 were investigated. There were 135 female and 18 male patients, with a mean age at the time of surgery of 16 (range, 8–18) years. The most common subtypes included classic PTC in 124 (81%), solid variant in 16 (10%), diffuse sclerosing variant in 7 (5%) and follicular variant in six (4%) according to the 5th edition of the WHO classification. At initial surgery, 49 patients (32%) had clinical lymph node metastases (cN1), 137 patients (90%) had pathological lymph node metastases (pN1), 73 patients (48%) had number of lymph node metastases (NLNMs) ≥10, 16 (10%) had gross extrathyroidal extension (ETE) and 18 (12%) had lung metastases. During a mean follow-up of 16 years, three (2%) patients died of their disease and 34 (25%) patients had recurrent disease. The 30-year cause-specific survival rate was 97.2%, and the 30-year disease-free survival (DFS) rate was 65.0%. On multivariate analysis, gross ETE, cN1 and NLNMs ≥10 identified as significant factors related to DFS (hazard ratio (HR) 4.13, confidence interval (CI) 1.48–9.96, P = 0.009; HR 2.34, CI 1.09–4.95, P = 0.0293; HR 2.81, CI 1.30–6.59, P = 0.008), but not histological subtype, were associated with disease recurrence. Histological subtypes were not associated with disease recurrence, but long-term follow-up of pediatric patients is necessary to investigate the biological characteristics.SynopsisThis retrospective study investigated the clinicopathological features and clinical outcomes of histological subtypes of PTC in a large series of pediatric patients treated at a single institution. It found that the prognosis of pediatric patients with PTC was excellent, but recurrence was common. In pediatric PTC, histological subtype did not affect survival and recurrence.

01 Apr 2025·Internal Medicine

Exacerbation of Thyroid Eye Disease and Dysthyroid Optic Neuropathy during Pregnancy

Article

Author: Hiruma, Shigenori ; Sugino, Kiminori ; Imai, Hideyuki ; Takahashi, Yasuyoshi ; Onda, Hidetoshi ; Kozaki, Ai ; Yoshihara, Ai ; Yoshimura Noh, Jaeduk ; Ichikawa, Masahiro ; Ito, Koichi ; Suzuki, Nami ; Watanabe, Natsuko ; Matsumoto, Masako ; Hirose, Rei ; Sankoda, Akiko ; Koshibu, Masakazu ; Fukushita, Miho

A 37-year-old, never-smoker, pregnant woman diagnosed with Graves' disease who had stable thyroid eye disease (TED) before pregnancy presented with aggravated proptosis and eyelid swelling at 13 weeks of pregnancy. Despite the administration of local triamcinolone and 3 cycles of corticosteroid pulse therapy from 25 to 28 weeks, the patient's visual acuity decline necessitated postpartum orbital decompression surgery. Although thyroid stimulating hormone (TSH) receptor antibody levels decreased during the mid- to late term of pregnancy, the TED worsened. This finding suggests that factors other than anti-TSH receptor antibodies may have a significant effect on disease severity.

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