Health‐related quality‐of‐life analyses from a multicenter, randomized, double‐blind phase 2 study of patients with differentiated thyroid cancer treated with lenvatinib 18 or 24 mg/day. (4th December 2022)

• Record Type: Journal Article
• Authors: Taylor, Matthew H.; Leboulleux, Sophie; Panaseykin, Yury; Konda, Bhavana; de La Fouchardiere, Christelle; Hughes, Brett G. M.; Gianoukakis, Andrew G.; Park, Young Joo; Romanov, Ilia; Krzyzanowska, Monika K.; Garbinsky, Diana; Sherif, Bintu; Pan, Jie Janice; Binder, Terri A.; Sauter, Nicholas; Xie, Ran; Brose, Marcia S.
• Is Part Of: Cancer medicine. Volume 12:Number 4(2023)
• Page Start: 4332
• Page End: 4342
• Publication Date: 2022-12-04
• Subjects: dose intensity -- HRQoL -- kinase inhibitor -- lenvatinib -- quality of life -- radioiodine‐refractory differentiated thyroid cancer; 616.994005
• DOI: 10.1002/cam4.5308
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Background: In the phase 2 double‐blind Study 211, a starting dose of lenvatinib 18 mg/day was compared with the approved starting dose of 24 mg/day in patients with radioiodine‐refractory differentiated thyroid cancer (RR‐DTC). Predefined criteria for noninferiority for efficacy in the 18 mg arm were not met; safety was similar in both arms. Impact of lenvatinib treatment on health‐related quality‐of‐life (HRQoL) was a secondary endpoint of Study 211. Methods: Patients with RR‐DTC were randomly assigned to a blinded starting dose of lenvatinib 18 mg/day or 24 mg/day. HRQoL was assessed at baseline, every 8 weeks until Week 24, then every 16 weeks, and at the off‐treatment visit, using the EQ‐5D‐3L and FACT‐G instruments. Completion and compliance rates, mean change from baseline, and times to first and definitive deterioration were evaluated. Results: Baseline EQ‐5D and FACT‐G scores, and overall changes from baseline, were comparable between patients in the lenvatinib 18 mg/day ( n = 77) and 24 mg/day arms ( n = 75). For the 18 mg versus 24 mg arms, least squares mean differences were −0.42 (95% CI −4.88, 4.03) for EQ‐5D‐VAS and 0.47 (95% CI −3.45, 4.39) for FACT‐G total. Time to first deterioration did not significantly favor either arm; EQ‐5D‐VAS HR [18 mg/24 mg] 0.93 (95% CI 0.61–1.40), EQ‐5D‐HUI HR [18 mg/24 mg] 0.68 (95% CI 0.44–1.05), FACT‐G total HR [18 mg/24 mg] 0.73 (95% CI 0.48–1.12). Time to definitive deterioration did not significantly favor either arm, though EQ‐5D‐VAS showed a trend in favor of the 24 mg arm (HR [18 mg/24 mg] 1.72; 95% CI 0.99–3.01); EQ‐5D‐HUI HR [18 mg/24 mg] was 0.96 (95% CI 0.57–1.63), FACT‐G total HR [18 mg/24 mg] was 0.72 (95% CI 0.43–1.21). Conclusions: In Study 211, HRQoL for patients in the lenvatinib 18 mg/day arm was not statistically different from that of patients in the 24 mg/day arm. These data further support the use of the approved lenvatinib starting dose of 24 mg/day in patients with RR‐DTC. ClinicalTrials.gov Number: NCT02702388. Abstract : Evaluation of the impact of lenvatinib treatment on health‐related quality‐of‐life was a secondary objective of the phase 2 double‐blinded Study 211. This study compared a starting dose of lenvatinib 18 mg/day with the approved starting dose of 24 mg/day in patients with radioiodine‐refractory differentiated thyroid cancer. Health‐related quality‐of‐life of patients in the 18 mg/day arm was not statistically different from that of patients in the 24 mg/day arm. These data, combined with results from the primary analysis (where the lenvatinib starting dose of 18 mg/day did not demonstrate noninferiority to the approved starting dose of lenvatinib 24 mg/day), support the use of the approved lenvatinib starting dose of 24 mg/day in patients with radioiodine‐refractory differentiated thyroid cancer.