文章：

晚期放射性碘难治性甲状腺癌中极低/低剂量乐伐替尼的治疗效果：一项单中心真实世界研究系列

Therapeutic Efficacy of a Very Low/Low Dose of Lenvatinib in Advanced Radioiodine-Refractory Thyroid Cancer: A Real-World Series from a Single Center

原文发布日期：17 July 2025

DOI: 10.3390/cancers17142372

类型: Article

开放获取: 是

英文摘要：

Background:Lenvatinib is a receptor tyrosine kinase inhibitor indicated for advanced radioiodine-refractory thyroid cancer (RAI-RTC). It is recommended to start at 24 mg per day; however, in patients who are at risk of severe adverse events, it may be reasonable to start at lower doses.Patients and Methods:We included 15 patients with RAI-RTC who started lenvatinib at a very low/low dose and evaluated the efficacy and safety.Results:Eight patients (53.3%) did not show progression of the disease, and about half of the patients (53.3%) were alive at the last follow-up visit. Up to 26.6% of patients achieved a partial response to therapy, with a notable volume reduction in the local and metastatic lesions. However, 80% of patients experienced adverse events, mainly of a moderate grade.Conclusions:Although these findings are based on a small sample size and a single-center study, treatment with lenvatinib at very low/low doses in fragile patients seems to be a promising strategy for the management of RAI-RTC, balancing effective disease control with a favorable safety profile.

摘要翻译： 

背景：乐伐替尼是一种受体酪氨酸激酶抑制剂，适用于治疗晚期放射性碘难治性甲状腺癌（RAI-RTC）。推荐起始剂量为每日24毫克，但对于存在严重不良事件风险的患者，从较低剂量开始治疗可能是合理的。 患者与方法：本研究纳入了15例RAI-RTC患者，这些患者以极低/低剂量起始乐伐替尼治疗，并对其疗效和安全性进行了评估。 结果：8例患者（53.3%）未出现疾病进展，约半数患者（53.3%）在末次随访时存活。高达26.6%的患者达到部分缓解，局部及转移病灶体积显著缩小。然而，80%的患者出现了不良事件，主要为中度级别。 结论：尽管这些发现基于小样本量和单中心研究，但对于体质脆弱的RAI-RTC患者，采用极低/低剂量乐伐替尼治疗似乎是一种有前景的治疗策略，能在有效控制疾病与良好安全性之间取得平衡。

原文链接：

Therapeutic Efficacy of a Very Low/Low Dose of Lenvatinib in Advanced Radioiodine-Refractory Thyroid Cancer: A Real-World Series from a Single Center