Recombinant Human Thyrotropin Use Has No Effect on Outcomes After Radioiodine in DTC

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Outcomes after radioiodine therapy are similar after preparation with either recombinant human thyrotropin or thyroid hormone withdrawal.
Outcomes after radioiodine therapy are similar after preparation with either recombinant human thyrotropin or thyroid hormone withdrawal.
The following article features coverage from the American Thyroid Association (ATA) 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

Recombinant human thyrotropin (rhTSH) resulted in similar rates of disease-free survival (DFS) compared with thyroid hormone withdrawal prior to radioiodine therapy (RIT) among patients with well-differentiated thyroid cancer (DTC), regardless of prognostic factors, according to a retrospective study presented at the 88th Annual Meeting of the American Thyroid Association in Washington, D.C.1

Although patients with DTC have a good prognosis, response to thyroidectomy and RIT can vary by some patient- and disease-related characteristics. It is unknown whether the use of rhTSH or thyroid hormone withdrawal preparation for RIT affects outcomes. The purpose of this study was to determine if the use of rhTSH is noninferior to thyroid hormone withdrawal on DFS, including when certain prognostic features are present.

The multicenter, retrospective, matched cohort study included 404 patients with pT1-T3 DTC with lymph node metastasis — but not distant metastasis — at the time of RIT. Patients were prepared with rhTSH or thyroid hormone withdrawal.

Demographic and tumor characteristics were similar between groups.

rhTSH was noninferior to thyroid hormone withdrawal at the first follow-up between 6 and 18 months after RIT, with a disease-free rate of 75.1% (95% CI, 68.6%-80.9%) with rhTSH compared with 71.9% (95% CI, 65.1%-78.0%) with thyroid hormone withdrawal.

Complete remission was also similar between groups at the last follow-up, between 29.7 and 36.7 months after RIT. Complete remission was achieved by 83.5% of patients who received rhTSH compared with 81.5% who underwent thyroid hormone withdrawal.

Prognostic factors such as gender, age, number or location of involved lymph nodes, tumor stage, or abnormal radioactive iodine whole-body scan affected DFS or complete remission between the rhTSH and thyroid hormone withdrawal groups.

The authors concluded that these results indicate that rhTSH preparation is noninferior to thyroid hormone withdrawal prior to RIT among patients with DTC staged pT1-T3/N1/M0.

Read more of Cancer Therapy Advisor's coverage of the ATA 2018 meeting by visiting the conference page.

Reference

  1. Taieb D, Leboulleux S, Bournaud C, et al. Recombinant human thyrotropin vs. thyroid hormone withdrawal in radioactive iodine therapy of thyroid cancer patients with nodal metastatic disease: influence of prognostic factors on follow-up clinical status. Presented at: the 88th Annual Meeting of the American Thyroid Association; Washington, D.C.: October 3-7, 2018. Abstract clinical oral 21.

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