Correlation of Performance Status and Neutrophil-Lymphocyte Ratio With Efficacy in Radioiodine-Refractory Differentiated Thyroid Cancer Treated With Lenvatinib.
Publication Title
Thyroid : official journal of the American Thyroid Association
Document Type
Article
Publication Date
2-26-2021
Keywords
oregon; portland; chiles
Abstract
BACKGROUND: Radioiodine-refractory differentiated thyroid cancer (RR-DTC) has a low 10-year patient-survival rate and is challenging to treat. Lenvatinib is a multikinase inhibitor approved for treatment of RR-DTC. This study aims to assess Eastern Cooperative Oncology Group performance status (ECOG PS) and neutrophil-to-lymphocyte ratio (NLR) as prognostic markers for patients with RR-DTC treated with lenvatinib.
METHODS: In this retrospective analysis of SELECT, patients randomly assigned to receive lenvatinib were classified according to baseline ECOG PS (0 or 1) or baseline NLR (≤3 or >3). The effects of baseline ECOG PS and NLR on progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) were evaluated. Additionally, the effects of baseline ECOG PS on the change in diameter of target lesions and correlations between baseline NLR and the sum of the diameters of target lesions were calculated.
RESULTS: Among patients who received lenvatinib, patients with a baseline ECOG PS of 0 had statistically improved PFS (hazard ratio [HR] 0.52 [95% confidence interval (CI): 0.35-0.77]; P=0.001), OS (HR 0.42 [95% CI: 0.26-0.69]; P=0.0004), and ORR (odds ratio [OR] 3.51 [95% CI: 2.02-6.10]; P3. Moreover, patients with a baseline NLR ≤3 had a trend toward increased ORR (OR 1.57 [95% CI: 0.94-2.64]; P=0.08) compared to patients with a baseline NLR >3. Treatment-emergent adverse events were generally similar among patients who received lenvatinib, irrespective of patients' ECOG PS at baseline.
CONCLUSIONS: Lower ECOG PS and NLR may provide prognostic value for improved efficacy in patients with RR-DTC. .
Area of Special Interest
Cancer
Specialty/Research Institute
Oncology
Specialty/Research Institute
Endocrinology
Specialty/Research Institute
Earle A. Chiles Research Institute
