Cediranib Alone Linked to Higher PFS Than in Conjunction With Lenalidomide for Differentiated Thyroid Cancer (DTC)

Cediranib in conjunction with lenalidomide is evidently not a more effective therapy for patients with advanced differentiated thyroid cancer (DTC) than cediranib alone, according to a study being presented at the 2016 annual meeting of American Society of Clinical Oncology (ASCO).¹

In a phase 2, randomized trial, investigators recruited 110 patients, 2 of which withdrew prior to treatment. Of the remaining 108 patients, 39 received only cediranib, a vascular endothelial growth factor receptor (VEGFR) inhibitor, and 69 received cediranib plus lenalidomide. Baseline characteristics were similar in patients of each cohort, though 1 prior treatment using a VEGF inhibitor was permitted and used as a stratification factor.

Median progression-free survival (PFS) was 21 months for patients receiving cediranib alone, and 11 months for those receiving cediranib plus lenalidomide. At this point the trial was discontinued for futility, and after another 10 months, PFS remained higher for those patients who received only cediranib: 1 and 2-year PFS were 13% and 14% higher, respectively than for those patients who received cediranib plus lenalidomide.

Despite overall survival (OS) being slightly higher for those patients randomized to receive both drugs (84% for 1 year and 66% for 2 years, compared to 82% for 1 year and 62% for 2 years for patients who received cediranib only), the authors concluded that therapy using a VEGFR inhibitor alone for patients with advanced DTC is promising. Adverse effects for patients in both cohorts included diarrhea, fatigue, hypertension, oral mucositis, neutropenia, and hand and foot syndrome. Patients receiving both drugs sometimes also experienced generalized weakness and proteinuria.

Reference

1. De Souza JA, Karrison T, Libao B, Worden FP, Krzyzanowska M, Hayes DN, et al. Randomized phase 2 trial of cediranib alone or cediranib plus lenalidomide in iodine 131-refractory differentiated thyroid cancer (DTC): A University of Chicago Phase 2 Consortium trial. Paper presented at: 2016 ASCO Annual Meeting; June 2016; Chicago, IL.