Follow-up study on biochemical and structural response in progressive radioactive io-dine-refractory differentiated thyroid cancer patients treated with apatinib
10.3969/j.issn.1000-8179.2017.08.172
- VernacularTitle:进展性碘难治性分化型甲状腺癌患者阿帕替尼治疗后血清学与影像学指标变化
- Author:
Xin ZHANG
;
Chen WANG
;
Jun LIANG
;
Yansong LIN
- Keywords:
apatinib;
radioactive iodine-refractory differentiated thyroid cancer;
tyrosine kinase inhibitor;
biochemical response;
struc-tural response
- From:
Chinese Journal of Clinical Oncology
2017;44(8):371-376
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the biochemical and structural changes of apatinib in patients with progressive radioactive iodine-re-fractory differentiated thyroid cancer (RAIR-DTC). Methods:The participants (n=10) were followed up since March 2016. Treatment ef-fect was evaluated in using both biochemical [thyroglobulin (Tg) and thyroglobulin antibody (Tg-Ab)] and structural responses (target lesions, TL). Adverse events were also recorded over time. Results:The median follow-up was 7.9 months. The Tg level declined rapid-ly within 6 weeks after apatinib treatment, and the average decline ranged from 60%to 90%, indicating the immediate biochemical re-sponse of apatinib in progressive RAIR-DTC. The Tg level tended to stabilize thereafter. However, the Tg level rebounded by 4%–135%when withdrawal was performed for 3–14 days. The number of TLs decreased rapidly within 8 weeks, and the average decreased ranged from 40%to 60%, indicating the presence of rapid structural responses. Thereafter, the number of TLs continued to stabilize. TLs, in contrast to Tg, were not significantly affected by drug withdrawal. The rate of change in Tg (Tgvn) was positively correlated with the rate of change in TL (TLvn) [TLvn=0.17×Tgvn+0.50 (r=0.56, P<0.05)]. The apatinib dose was adjusted due to adverse events, which could be relieved after 3 to 14 days of withdrawal. Apatinib can effectively control the disease even at a reduced dose of 250 mg/d. Conclusion:Apatinib treatment showed a fast and sustainable biochemical and structural responses. Tg could be regarded as an objec-tive indicator. Tgvn is positively correlated with TLvn, and the response of Tg is more sensitive than that of TLs.
