SESSA, FRANCESCA (2022) The management of patients with RAI-R thyroid cancer and the evolution towards personalized treatment. [Tesi di dottorato]
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| Tipologia del documento: | Tesi di dottorato |
|---|---|
| Lingua: | English |
| Titolo: | The management of patients with RAI-R thyroid cancer and the evolution towards personalized treatment |
| Autori: | Autore Email SESSA, FRANCESCA sessafrancescaf@libero.it |
| Data: | 2022 |
| Numero di pagine: | 62 |
| Istituzione: | Università degli Studi di Napoli Federico II |
| Dipartimento: | Sanità Pubblica |
| Dottorato: | Sanità pubblica e medicina preventiva |
| Ciclo di dottorato: | 35 |
| Coordinatore del Corso di dottorato: | nome email TRIASSI, MARIA maria.triassi@unina.it |
| Tutor: | nome email SALVATORE, DOMENICO [non definito] |
| Data: | 2022 |
| Numero di pagine: | 62 |
| Parole chiave: | RAI-R thyroid cancer-oligoprogression-TKIs |
| Settori scientifico-disciplinari del MIUR: | Area 06 - Scienze mediche > MED/42 - Igiene generale e applicat |
| Depositato il: | 20 Dic 2022 08:57 |
| Ultima modifica: | 09 Apr 2025 13:28 |
| URI: | http://www.fedoa.unina.it/id/eprint/14724 |
Abstract
During the last decades, the knowledge on thyroid cancer molecular biology has led to the evolution of a number of novel therapies for these tumors, mainly tyrosine kinase inhibitors. This study analysed the results of the treatment with lenvatinib in 18 patients during a median follow-up of 37.1 months. 14 patients received lenvatinib at a starting dose of 24 mg, while 4 patients started with a lower dose, due to worst general condition. Moreover, the dose has been reduced progressively according to the severity of adverse events. The most common adverse events (grade 1-3) have been: hypertension, diarrhoea, asthenia, weight loss, nausea, anorexia. All the AEs have been treated with specific drugs, as indicated in guidelines. The progression free-survival (PFS) has been 64% at 36 months and 48% at 60 months. The overall survival (OS) has been 78%. The response to the therapy has been: stable disease (44%), partial response (22%), global progressive disease (17%), oligoprogressive disease (17%). In case of oligoprogression, we decided to treat the progressive sites of disease with local ablative therapy and to continue the systemic therapy with lenvatinib. There are scarce published data for this approach in thyroid cancer, because of the relatively short time since the approval of TKIs in this scenario and the heterogeneity of the clinical presentations. Finally, the appearance of drug resistance makes the development of more effective further targeted therapies necessary, towards a personalized approach, based on tumour’ mutational pattern.
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