Eur J Cancer: Levatinib significantly prolongs the survival of patients with radioactive iodine re treatable differentiated thyroid cancer, even if lung metastasis has occurred!

Lung metastasis in patients with radioactive iodine re treatable differentiated thyroid cancer (RR-DTC) may worsen the total survival (OS) prognostic.
the SELECT trial is a Phase 3 study in which Tahara et al. analyzed the effects of pulmonary metastasis on patients' survival prognostics.
in this trial, 392 RR-DTC patients were randomly assigned to the Levatinib group (lenvatinib, 24 mg/day, n=261) or the placebo group (n=131).
patients treated with placebo were crossed to the Levatinib group (open label) after progression.
patients were grouped according to the size of baseline pulmonary metastasis lesions.
patients in each subgroup were treated with prognostic levatinib in each baseline pulmonary metastasis subgroup, with a total of 226 patients: ≥1.0 cm (n=199), ≥1.5 cm (n=150), ≥2.0 cm (n=94) and slt;2.0 cm (n=105).
there was no statistically significant difference in OS between treatment groups in patients with pulmonary metastasis (HR 0.76, 95% CI 0.57-1.01; p=0.0549).
patients in the placebo group and the levatinib group had a medium OS of 44.7 months (levatinib group≥) vs 33.1 months (placebo group) (HR 0.63, 95% CI 0.47-0.85, p-0.0025), respectively.
were treated with pulmonary metastasis (≥1.0 cm, ≥1.5 cm, ≥2.0 cm and slt;2.0 compared to the placebo group cm) patients had significantly longer OS≥ and patients in the metastasis ≥2.0 cm subgroup had shorter mesos than other subgroups (34.7 vs 44.1-49.2 months).
multivariable analysis showed that, after the correction of the basic characteristics, levatinib significantly prolonged OS in patients with pulmonary metastasis ≥ 1.0 cm.
, levatinib therapy can extend the survival of patients with RR-DTC with pulmonary metastasis ≥1.0 cm compared to placebo.