Preliminary study of apatinib combined with 131I therapy in patients with progressive metastatic differentiated thyroid cancer
10.3760/cma.j.cn321828-20220830-00274
- VernacularTitle:阿帕替尼联合 131I治疗进展性、转移性分化型甲状腺癌患者的初步研究
- Author:
Jun WANG
1
;
Liang SHI
;
Xiaowei TANG
;
Shaohua LI
;
Yudan NI
;
Feng WANG
Author Information
1. 南京医科大学附属南京医院、南京市第一医院核医学科，南京 210006
- Keywords:
Thyroid neoplasms;
Molecular targeted therapy;
Drug therapy;
Radiotherapy;
Iodine radioisotopes;
Thyroglobulin
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2022;42(11):650-655
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of apatinib combined with 131I therapy for progressive metastatic differentiated thyroid cancer (pmDTC). Methods:Seven patients (1 male, 6 females, age: 58(51, 66) years) with pmDTC in Nanjing First Hospital between November 2017 and February 2022 were enrolled. Patients received oral apatinib 500 mg once daily. The effect of apatinib on differentiated thyroid cancer were evaluated by using 18F-FDG PET/CT or CT at 3(2, 4) months after the treatment. Then in the state of continuous administration of apatinib, 131I therapy was initiated. 18F-FDG PET/CT or CT was performed at 3 months after apatinib combined with 131I therapy to evaluate the response. Both thyroglobulin (Tg) and Tg antibody levels were monitored every 4 to 8 weeks after the treatment. Wilcoxon signed-rank test was used for data analysis. Results:Five patients achieved partial response after 3(2, 4) months of apatinib treatment and two patients had progressive disease. The disease control rate and objective response rate were both 5/7. Five patients achieved partial response and two patients were in stable disease after apatinib combined with 131I therapy for 2(1, 2) times, with disease control rate and objective response rate of 7/7 and 5/7, respectively. The Tg level declined from 8 644(2 504, 16 300) μg/L (baseline) to 143(7, 3 574) μg/L( z=-2.37, P=0.018) after apatinib combined with 131I therapy. In addition, one patient had a significant increase in 131I uptake in the tumor lesions after long-term treatment with apatinib. Conclusions:Apatinib has obvious anti-tumor effects and high objective response rate is observed after apatinib treatment in patients with pmDTC. The anti-tumor effects are more prominent after combined with 131I therapy. Long-term treatment with apatinib may alter the tumor microenvironment to induce differentiation and increase iodine uptake in tumor lesions, which need to be further studied.
