Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;10(1):145-158.
doi: 10.1007/s40801-022-00346-y. Epub 2022 Dec 17.

Multikinase Inhibitor Treatment Patterns for Advanced Thyroid Cancer in Japan: An Administrative Claims Database Study

Chie Masaki  1 , Kiminori Sugino  2 , Yoshinori Tanizawa  3 , Kenichi Nakamura  3 , Yui Okada  3 , Zhihong Cai  3 , Takahiro Okamoto  4
Affiliations

Multikinase Inhibitor Treatment Patterns for Advanced Thyroid Cancer in Japan: An Administrative Claims Database Study

Chie Masaki et al. Drugs Real World Outcomes. 2023 Mar.

Abstract

Background: The multikinase inhibitors (MKIs) sorafenib, lenvatinib, and vandetanib are approved for advanced thyroid cancer (TC) in Japan. How sequential treatment with MKIs is conducted in Japanese clinical practice is unknown.

Methods: This retrospective observational cohort study used a Japanese administrative claims database (April 2008-September 2021). Patients with a confirmed TC subtype diagnosis of papillary (PTC), follicular (FTC), medullary (MTC), or anaplastic (ATC), who received MKI treatment after TC diagnosis within the index period (June 2014-August 2021), were included. Overall MKI treatment duration was estimated by Kaplan-Meier analysis.

Results: The analysis population included 795 patients (PTC, N = 447; FTC, N = 86; MTC, N = 32; ATC, N = 230). Median age was ≥ 64 years; most patients (> 60%) were female except for the MTC subgroup (43.8%). First-line (1L) MKI treatment was mainly lenvatinib for PTC (81.7%), FTC (83.7%), and ATC (97.8%), and vandetanib for MTC (62.5%). Among patients discontinuing 1L MKI treatment and evaluable for subsequent therapy [PTC: 57.9% (259/447); FTC: 48.8% (42/86); MTC: 62.5% (20/32); ATC: 70.4% (162/230)], 26.3% (68/259), 21.4% (9/42), 50.0% (10/20), and 4.9% (8/162) of PTC, FTC, MTC, and ATC patients, respectively, received second-line (2L) treatment. Median (95% CI) overall MKI treatment duration was 21.2 (17.9-27.5), 43.9 (30.9-not assessable), 39.0 (17.7-not assessable), and 4.0 (3.0-4.8) months for PTC, FTC, MTC, and ATC, respectively.

Conclusion: Advanced TC treatment options are limited. In this study, most patients received only 1L MKI treatment; of those who discontinued 1L, ≤ 50% progressed to 2L.

PubMed Disclaimer

Conflict of interest statement

CM and TO have no conflicts of interest to declare. KS received honorarium for lectures from Bayer, Eisai Co., Ltd. and Eli Lilly and Company. YT, KN, YO, and ZC are employees of Eli Lilly Japan K.K. and own stocks of Eli Lilly and Company.

Figures

Fig. 1
Fig. 1
Study design. aFirst diagnosis of TC in the database. bFirst MKI drug prescription in or after the month with the first TC diagnosis. 1L/2L first-/second-line, DB database, MKI multikinase inhibitor, TC thyroid cancer
Fig. 2
Fig. 2
Patient flow diagram. ATC anaplastic thyroid cancer, FTC follicular thyroid cancer, ICD-10 International Classification of Diseases, Tenth Revision, MKI multikinase inhibitor, MTC medullary thyroid cancer, PTC papillary thyroid cancer, TC thyroid cancer
Fig. 3
Fig. 3
Treatment patterns with MKI and taxane. aThe number of patients who were evaluable for 2L treatment analyses were those who had finished or terminated 1L treatment. The end of 1L treatment was when the patient terminated all the drugs in the regimen or started a new MKI drug or taxane that was not included in the regimen, whichever occurred first: PTC, N = 259; FTC, N = 42; MTC, N = 20; ATC, N = 162. 1L/2L/3L first-/second-/third-line, ATC anaplastic thyroid cancer, FTC follicular thyroid cancer, LEN lenvatinib, MKI multikinase inhibitor, MTC medullary thyroid cancer, PTC papillary thyroid cancer, SOR sorafenib, TAX taxane, VAN vandetanib
Fig. 4
Fig. 4
a Overall MKI treatment duration and b time to death during hospitalization. Shading indicates 95% CI. ATC anaplastic thyroid cancer, CI confidence interval, FTC follicular thyroid cancer, MKI multikinase inhibitor, MTC medullary thyroid cancer, NA not assessable, PTC papillary thyroid cancer
See this image and copyright information in PMC

References

    1. Cancer Statistics. Cancer Information Service, National Cancer Center, Japan (National Cancer Registry, Ministry of Health, Labour and Welfare). Section 2.2. Affected. 1. National Cancer Registration. 2016–2018. https://ganjoho.jp/reg_stat/statistics/data/dl/index.html#anchor2. Accessed 21 Jun 2022.
    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. Lancet. 2016;388(10061):2783–2795. doi: 10.1016/s0140-6736(16)30172-6. - DOI - PubMed
    1. Nikiforov YE, Nikiforova MN. Molecular genetics and diagnosis of thyroid cancer. Nat Rev Endocrinol. 2011;7(10):569–580. doi: 10.1038/nrendo.2011.142. - DOI - PubMed
    1. Ito Y, Masuoka H, Fukushima M, Inoue H, Kihara M, Tomoda C, et al. Prognosis and prognostic factors of patients with papillary carcinoma showing distant metastasis at surgery (M1 patients) in Japan. Endocr J. 2010;57(6):523–531. doi: 10.1507/endocrj.k10e-019. - DOI - PubMed