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Table 4 Summary results of studies that deployed novel therapeutic modalities in patients with distant metastases from thyroid carcinomas

From: Spinal metastasis in thyroid cancer

Author, Year Number of patients (% female) Median age (yrs) at time of symptomatic distant metastatic disease (range) Thyroid cancer histology (%) Percentage of patients with bone/spinal metastasis Signs and symptoms of distant metastasis/indication for intervention Intervention for distant metastasis (% of patients) Other metastases (%) Main outcome(s)
Kloos et al., 2009 Total 56 (44.6%): Treatment group 19 (42%); Control group 37 (45.9%) - Papillary (73%), Follicular (4%), Hurthle cell (16%), Anaplastic (7%) BM (21%) Evaluate the activity of sorafenib in metastatic thyroid carcinoma Treatment group; sorafenib 400 mg PO bd Lung (96), lymph (94%), other (14%) Partial response in 15% of patients (7.5 months median duration). Median progression-free survival was 15 months
Cabanillas et al., 2010 15 (60%) 61 (38–83) PWD (53.3%), FWD (33.3%), Hurthle (13.3%) BM (26.7%) Evaluate the activity of sorafenib and sunitinib in progressive and radioactive resistant DTC Sorafenib 200–400 mg PO bd 86.7%, sunitinib 50 mg PO od 13.3% Lymph (73.3%), lung (66.7%), pleura (13.3%) SD 9 (60%), PR 3 (20%), PD 3 (20%). 2 yr survival 67%
Orita et al., 2011 Total 50 (72%): Treatment group 22 (68.2%); Control 28 (75%) 59 (32–77) PWD (52%), FWD (48%) SM (40%), BM (100%) Evaluate the efficacy of ZA for treatment of symptomatic BM in DTC Treatment group; ZA 4 mg IV/month (100%), Surgery (18%), ERT (77%), RAI (50%) Others (60%) Treatment group/control SRE-free 3 yr survival: 86%/50%, mortality 54%
Wells et al., 2012 Total 331 (42.6%): Treatment group 231 (42%); Control group 100 (44%) - Advanced MTC (100%) Treatment group BM (34%), control group BM (40%) Evaluate the efficacy of vandetanib in advanced or metastatic MTC Treatment group; vandetanib 300 mg PO Hepatic (46.5%), lymph nodes (40.8%), respiratory (38.1%), neck (10.0%) Significant prolongation of PFS with vandetanib compared with placebo. PD 37%, mortality 15%
  1. DTC; differentiated thyroid carcinoma, PWD; papillary well differentiated, FWD; follicular well differentiated, MTC; medullary thyroid carcinoma, PDTC; poorly differentiated thyroid carcinoma, FLD; follicular less differentiated, UTC; undifferentiated thyroid carcinoma, T; thoracic, L; lumbar, C; cervical, BM; bone metastasis, SM; spinal metastasis, SSC; spinal cord compression, RAI; radioactive iodine (131-I), ERT; external radiotherapy, CT; chemotherapy, SET; selective embolization therapy, TES; total en bloc spondylectomy, ZA; zolendronic acid, NED; no evidence of disease, SD; stable disease, CR; complete remission, PR; partial response, PD; progressive disease, AWD; alive with disease, DOD; death of disease, SRE; skeletal-related events, PFS; progression-free survival, DSS; disease-specific survival, yr; year.