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Thyroid. 2013 May;23(5):600-4. doi: 10.1089/thy.2012.0103. Epub 2013 Apr 18.

Phase II trial of sorafenib in patients with advanced anaplastic carcinoma of the thyroid.

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  • 1Division of Hematology/Oncology, Seidman Cancer Center, University Hospitals , Cleveland, OH 44106, USA.

Abstract

BACKGROUND:

Anaplastic thyroid cancer (ATC) is a rare but highly aggressive malignancy with a median survival of 3-5 months. The BRAF oncogene is mutated to its active form in up to 24% of ATC cases. Sorafenib is a tyrosine kinase inhibitor that acts on the RAF-1 serine/threonine kinase. In preclinical mouse models, sorafenib inhibits the growth of ATC xenografts and improves survival. No study of sorafenib in ATC has been conducted. We conducted a multi-institutional phase II trial of sorafenib in patients with ATC who had failed up to two previous therapies.

METHODS:

The primary endpoint of the trial was the Response Evaluation Criteria In Solid Tumors (RECIST)-defined imaging response rate. Twenty patients with ATC were treated with sorafenib 400 mg twice daily.

RESULTS:

Two of the 20 patients had a partial response (10%) and an additional 5 of 20 (25%) had stable disease. The duration of response in the two responders was 10 and 27 months, respectively. For the patients with stable disease, the median duration was 4 months (range 3-11 months). The overall median progression-free survival was 1.9 months with a median and a 1-year survival of 3.9 months and 20%, respectively. Toxicity was manageable and as previously described for sorafenib, including hypertension and skin rash.

CONCLUSION:

Sorafenib has activity in ATC, but at a low frequency and similar to our previous experience with fosbretabulin. One patient with a response had previously progressed on fosbretabulin. Toxicities were both predictable and manageable.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00126568.

PMID:
23113752
[PubMed - indexed for MEDLINE]
PMCID:
PMC3643255
Free PMC Article
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