Patients who have no treatment options. They are patients with radioiodine-refractory differentiated thyroid cancer, a therapy that is used when patients have a high risk of disease recurrence, incomplete tumor removal or distant metastasis. These are patients with a poor prognosis with an estimated average survival of three to five years from the diagnosis of metastatic lesions. For them, positive news arrives from the congress of the American Society of Clinical Oncology: the molecule cabozantinib extends the time free from disease compared to placebo.
“As a result of progression, RAI-refractory differentiated thyroid cancer patients currently lack a standard of care following VEGFR-targeted drug therapy, consequently the positive results of the COSMIC-311 study are an important clinical advance for those who need additional treatment options, ”said Marcia S. Brose, MD, Ph.D., Full Professor of Otorhinolaryngology: Head and Neck Surgery and Director of the Center for Rare Cancers and Personalized Therapy at the University’s Abramson Cancer Center of Pennsylvania, and principal investigator of the COSMIC-311 study. “The significant improvement in progression-free survival and the favorable trend in overall survival suggest that cabozantinib may be an important new treatment option for these patients.”
Cabozantinib demonstrated a significant reduction in the risk of disease progression or death by 78% compared to placebo. In addition, a reduction in major lesion size was observed in 76% of cabozantinib-treated patients compared with 29% of placebo-treated patients. Finally, the safety profile of cabozantinib was consistent with that previously observed and adverse events were manageable with dose adjustment.
Differential carcinoma of the thyroid RAI refractory
In 2020, more than 580,000 new cases of thyroid cancer were diagnosed worldwide, numbers that make thyroid cancer the ninth most common cancer globally, with an incidence three times higher in women than in men. Thyroid cancers include differentiated, medullary and anaplastic forms. Differentiated thyroid cancers make up about 90-95% of thyroid cancers: they include papillary, follicular and Hürthle cell forms. Differentiated thyroid cancer (DTC) is commonly treated with surgery, followed by radioiodine ablation of residual thyroid tissue, but approximately 5-15% of cases are resistant to RAI treatment.
Patients with refractory RAI DTC have a poor prognosis with a median estimated survival of three to five years from diagnosis of metastatic lesions.
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