Sorafenib in iodo-refractory thyroid cancer : Experience of medical oncology department of Pierre and Marie Curie Center Algiers Algeria

Abstract

Background : Although thyroid cancer ususally has a excellent prognosis,few therapeutic options are available in the refractory setting, Its multidisciplinary approach is the subject of recommendations regularly updated .The Sorafenib (a multi kinase inhibitor) was recently distinguished as a valid therapeutic option in case the exhaust with standard therapy (surgery ± radioiodine)
Aim:is to evaluate the efficacy and safety of sorafenib .
Methods: We report a retrospective analysis of 53 patients followed for metastatic thyroid cancer and resistant to radioactive iodine, collected in our medical oncology Pierre and Marie Curie center in Algiers .
Results: Of 53 patients , we treated 40 symptomatic patients with sorafenib, 15 men and 25 women with a sex ratio of 0.6, the average age is 54.58 years (22-79) Histologically we have 15 papillary carcinomas, 13 vesicular carcinomas, 10 poorly differentiated carcinomas, 02 mixed papillary and medullary carcinoma. 38 patients benefited from thyroid surgery, 40 from iratherapy at an average dose of 621 mci.
. The metastatic sites were: Lung (75%), bone (44%), liver (16%), brain (9%), adrenal (6%), skin (6%). 16% had local and lymph node recurrence .
Patients received an average of 11 courses of sorafenib at a daily dose of 800 mg per day
36 patients are evaluable for response, we obtained 25 stabilizations, 04 partial responses and 07 progressions. The average progression-free survival is 13 months.

The most common adverse events are: hand foot syndrome grade III (n = 2), moderate hypertension (n = 07),diarrhea grade 2 n=6 , skin reaction grade 3 (n = 1).
CONCLUSION:
Sorafenib is a promising treatment option for patients with iodine-refractory thyroid cancer
Keywords :
Thyroid cancer, iodine refractor, tyrosine kinase inhibitors