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. 2022 Mar 2;6(5):bvac032.
doi: 10.1210/jendso/bvac032. eCollection 2022 May 1.

Metastatic Differentiated Thyroid Cancer Survival Is Unaffected by Mode of Preparation for 131I Administration

Cristiane J Gomes-Lima  1   2 , Sanjita Chittimoju  3 , Leen Wehbeh  3 , Sunita Dia  3 , Prathyusha Pagadala  3 , Mohammad Al-Jundi  3 , Sakshi Jhawar  4 , Eshetu Tefera  5 , Mihriye Mete  5 , Joanna Klubo-Gwiezdzinska  6 , Douglas Van Nostrand  1   7 , Jacqueline Jonklaas  8 , Leonard Wartofsky  2 , Kenneth D Burman  2   8
Affiliations

Metastatic Differentiated Thyroid Cancer Survival Is Unaffected by Mode of Preparation for 131I Administration

Cristiane J Gomes-Lima et al. J Endocr Soc. .

Abstract

Context: Recombinant human thyrotropin (rhTSH) is currently not Food and Drug Administration approved for the treatment of high-risk patients with differentiated thyroid cancer (DTC).

Objective: The goal of our study was to compare the outcomes in higher-risk patients with metastatic DTC prepared for radioiodine (RAI) therapy with rhTSH vs thyroid hormone withdrawal (THW).

Methods: A retrospective chart review was performed of patients with metastatic DTC in follow-up at MedStar Washington Hospital Center and MedStar Georgetown University Hospital from 2009 to 2017. Patients were divided according to their preparation for RAI therapy, with assessment of progression-free survival (PFS) and overall survival (OS).

Results: Fifty-five patients with distant metastases (16 men, 39 women) were prepared for RAI therapy exclusively either with rhTSH (n = 27) or with THW (n = 28). There were no statistically significant differences between the groups regarding clinicopathological features and history of RAI therapies. The median follow-up time for patients with rhTSH-aided therapies was 4.2 years (range, 3.3-5.5 years) and for patients with THW-aided therapies was 6.8 years (range, 4.2-11.6 years) (P = .002). Multivariate analysis showed that the method of thyrotropin stimulation was not associated with a difference in PFS or OS.

Conclusion: As has been shown previously for low-risk DTC, this study indicates that the mode of preparation for RAI therapy does not appear to influence the outcomes of patients with metastatic DTC. PFS and OS were similar for patients with THW-aided or rhTSH-aided RAI therapies.

Keywords: differentiated thyroid cancer; metastatic DTC; radioiodine therapy; recombinant TSH; thyroid hormone withdrawal.

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Figures

Figure 1.
Figure 1.
Progression-free survival in recombinant human thyrotropin (rhTSH) and thyroid hormone withdrawal (THW) groups.
Figure 2.
Figure 2.
Overall survival in recombinant human thyrotropin (rhTSH) and thyroid hormone withdrawal (THW) groups.
Figure 3.
Figure 3.
Best overall response.
Figure 4.
Figure 4.
Target lesion evaluation according to RECIST 1.1.
See this image and copyright information in PMC

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