Publications by authors named "Martin J Schlumberger"
Radioiodine (RAI)-refractory thyroid cancer is an uncommon entity, occurring with an estimated incidence of 4-5 cases/year/million people. RAI refractoriness is more frequent in older patients, in those with large metastases, in poorly differentiated thyroid cancer, and in those tumors with high 18-fluordeoxyglucose uptake on PET/CT. These patients have a 10-year survival rate of less than 10%.
View Article and Find Full Text PDFBackground: Cabozantinib significantly prolonged progression-free survival (PFS) versus a placebo in patients with progressive, metastatic medullary thyroid cancer (MTC; P < .001). An exploratory analysis of phase 3 trial data evaluated the influence of rearranged during transfection (RET) and RAS (HRAS, KRAS, and NRAS) mutations on cabozantinib clinical activity.
View Article and Find Full Text PDFBackground: Patients with radioactive iodine ((131)I)-refractory locally advanced or metastatic differentiated thyroid cancer have a poor prognosis because of the absence of effective treatment options. In this study, we assessed the efficacy and safety of orally administered sorafenib in the treatment of patients with this type of cancer.
Methods: In this multicentre, randomised, double-blind, placebo-controlled, phase 3 trial (DECISION), we investigated sorafenib (400 mg orally twice daily) in patients with radioactive iodine-refractory locally advanced or metastatic differentiated thyroid cancer that had progressed within the past 14 months.
Purpose: Cabozantinib, a tyrosine kinase inhibitor (TKI) of hepatocyte growth factor receptor (MET), vascular endothelial growth factor receptor 2, and rearranged during transfection (RET), demonstrated clinical activity in patients with medullary thyroid cancer (MTC) in phase I.
Patients And Methods: We conducted a double-blind, phase III trial comparing cabozantinib with placebo in 330 patients with documented radiographic progression of metastatic MTC. Patients were randomly assigned (2:1) to cabozantinib (140 mg per day) or placebo.
Background: No effective standard treatment exists for patients with radioiodine-refractory, advanced differentiated thyroid carcinoma. We aimed to assess efficacy and safety of vandetanib, a tyrosine kinase inhibitor of RET, VEGFR and EGFR signalling, in this setting.
Methods: In this randomised, double-blind, phase 2 trial, we enrolled adults (aged ≥18 years) with locally advanced or metastatic differentiated thyroid carcinoma (papillary, follicular, or poorly differentiated) at 16 European medical centres.
Purpose: There is no effective therapy for patients with advanced medullary thyroid carcinoma (MTC). Vandetanib, a once-daily oral inhibitor of RET kinase, vascular endothelial growth factor receptor, and epidermal growth factor receptor signaling, has previously shown antitumor activity in a phase II study of patients with advanced hereditary MTC.
Patients And Methods: Patients with advanced MTC were randomly assigned in a 2:1 ratio to receive vandetanib 300 mg/d or placebo.
Article Synopsis
- Antiangiogenic therapies, like motesanib, show promise for treating advanced thyroid cancer, but identifying which patients benefit most is challenging.
- An exploratory analysis of a phase 2 study found that changes in circulating biomarkers, particularly placental growth factor (PlGF) and soluble VEGF receptor 2, may predict tumor response and progression-free survival.
- Patients with significant increases in PlGF (4.7-fold) saw a much higher response rate (30%) compared to those with lower changes (3%), while those with lower baseline serum VEGF levels exhibited longer progression-free survival.
Article Synopsis
- - This phase II study focused on motesanib, a new drug targeting specific growth factor receptors, to treat advanced medullary thyroid cancer (MTC) in patients who have progressive or symptomatic disease.
- - Out of 91 patients treated with motesanib, only 2% showed an objective response, while 81% had stable disease; median progression-free survival lasted 48 weeks, with many experiencing decreases in tumor markers.
- - Common side effects included diarrhea, fatigue, hypothyroidism, hypertension, and anorexia, but overall, the study demonstrates that motesanib can help maintain stable disease in a significant number of MTC patients, despite the low rate of complete responses.
Article Synopsis
- The study evaluates motesanib diphosphate, a new oral drug that inhibits VEGF receptors, in 93 patients with aggressive, radioiodine-resistant differentiated thyroid cancer.
- Results showed a 14% objective response rate, with 67% achieving stable disease for at least 24 weeks and a median progression-free survival of 40 weeks.
- Common side effects included diarrhea, hypertension, fatigue, and weight loss, but 81% of patients exhibited decreased serum thyroglobulin levels, suggesting some effectiveness of the treatment.
The use of radioactive iodine ((131)I) for the treatment of thyroid carcinoma has changed over the past 50 y. These changes are based on increasing awareness of the biophysical properties of (131)I and new discoveries concerning the biology of iodine handling by thyroid cells. The therapeutic administration of (131)I for thyroid remnant ablation and for metastases requires an appreciation of iodine clearance kinetics, of factors that can alter the occupancy time of (131)I within lesions, and of the role of thyroid-stimulating hormone in stimulating the sodium-iodide symporter.
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