Adding immune modulator to targeted therapy does not improve survival in difficult-to-treat thyroid cancer

Sept. 22, 2023
A multicenter, open-label, randomized, phase II study of cediranib with or without lenalidomide in iodine 131-refractory differentiated thyroid cancer.

Results of a multicenter phase II clinical trial led by the University of Chicago Medicine Comprehensive Cancer Center show that adding an immunomodulatory agent to treatment with the targeted tyrosine kinase inhibitor (TKI) cediranib did not make a difference in outcomes for treating patients with an advanced form of thyroid cancer that develops from thyroid follicular cells called differentiated thyroid cancer (DTC).

The findings were published in Annals of Oncology on May 13, 2023.

UChicago Medicine oncologists Ari Rosenberg, MD, and Everett Vokes, MD, set out to test the safety and efficacy of cediranib, a TKI that targets multiple VEGFRs. Furthermore, the researchers hypothesized that this group of patients would have an additional benefit if the drug was combined with an immunomodulatory agent known as lenalidomide. This drug is also known to block angiogenesis and has anti-tumor properties in other cancers, and early clinical trials indicated that it exhibits similar activity against DTC. Recent combination therapies consisting of traditional therapies and immunotherapies have yielded superior results in many cancer conditions.

In a phase II clinical trial, 108 patients were enrolled from various hospitals in the United States and Canada. They were randomly assigned to either of the two treatment arms: 39 patients in the cediranib alone group and 69 patients in the cediranib with lenalidomide group. The cediranib alone group achieved median progression-free survival (PFS) of 14.8 months, and 44% of patients had a complete or partial disappearance of tumor as assessed by objective response rate (ORR). Surprisingly, the addition of lenalidomide to cediranib didn’t prove to be any better than treatment with cediranib alone.

Final analysis of the data demonstrated that cediranib is an active agent, which means that the ORR and PFS of cediranib appear similar to other approved VEGFR-targeted tyrosine kinase inhibitors in DTC, including lenvatinib, sorafenib and vandetanib.

University of Chicago Medicine release on Newswise