Ezra Cohen, MD, Associate Director, Professor of Medicine Moores Cancer Center, UC San Diego, discusses if lenvatinib should be used in the frontline or second-line setting in differentiated thyroid cancer.
Ezra Cohen, MD, associate director, professor of Medicine, Moores Cancer Center, UC San Diego, discusses whether lenvatinib should be used in the frontline or second-line setting in differentiated thyroid cancer.
With both lenvatinib and sorafenib approved in thyroid cancer, oncologists are divided on which agent to use first, says Cohen. Lenvatinib had impressive clinical data in a phase III trial, including a 63% response rate and an 18-month progression-free survival (PFS) rate. Based on these results, some oncologists believe it should be utilized in the first-line setting, he says.
However, lenvatinib was tested in second-line, as one-quarter of the patients in the phase III study had previously taken a VEGF inhibitor, and it still demonstrated almost the same PFS. Because of this, some oncologists feel that sorafenib should be given first followed by lenvatinib.
Cohen personally feels that the best agents should be used first, and therefor he prefers using lenvatinib in the first-line setting.