scholarly journals Analysis of the efficacy and toxicity of sorafenib in thyroid cancer: a phase II study in a UK based population

2011 ◽  
Vol 165 (2) ◽  
pp. 315-322 ◽  
Author(s):  
Merina Ahmed ◽  
Yolanda Barbachano ◽  
Angela Riddell ◽  
Jen Hickey ◽  
Katie L Newbold ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Differentiated Thyroid Carcinoma ◽  
Free Survival ◽  
Hand Foot Syndrome ◽  
Secondary Endpoints ◽  
Radiological Response ◽  
Dose Reductions

AimTo evaluate the tolerability and efficacy of sorafenib in patients with thyroid carcinoma.MethodsPatients with progressive locally advanced/metastatic medullary thyroid carcinoma (MTC), or differentiated thyroid carcinoma (DTC) with non-radioiodine-avid disease, were treated with sorafenib 400 mg twice daily until disease progression. The primary endpoint was the radiological response rate (RR) at 6 months. Secondary endpoints were RR at 3, 9 and 12 months, biochemical responses, toxicity, biomarker analyses and progression free and overall survival (OS).ResultsA total of 34 patients were recruited to the study (15 medullary and 19 differentiated). After 6 months, the RR rate was 15% and a further 74% of patients achieved stable disease in the first 6 months. After 12 months of treatment, the RR was 21%. In the MTC patients, the RR at 12 months was 25% and OS was 100%. In DTC patients corresponding rates were 18 and 79% respectively. Median overall and progression-free survival points were not reached at 19 months. Commonest adverse events included hand–foot syndrome, other skin toxicities, diarrhoea and alopecia. Dose reduction was required in 79% patients. Median time on treatment was 16.5 months.ConclusionThis study demonstrates that sorafenib is tolerable at reduced doses over prolonged periods of time in patients with thyroid cancer. Sorafenib leads to radiological and biochemical stabilisation of disease in the majority of these patients despite dose reductions.

scholarly journals Lenvatinib Administered via Nasogastric Tube in Poorly Differentiated Thyroid Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Eleonora Molinaro ◽  
David Viola ◽  
Nicola Viola ◽  
Pierpaolo Falcetta ◽  
Francesca Orsolini ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Gastric Tube ◽  
Kinase Inhibitors ◽  
Locally Advanced ◽  
Differentiated Thyroid Carcinoma ◽  
Cervical Esophagus ◽  
Extrinsic Compression ◽  
Poorly Differentiated ◽  
Iodine 131

Background. The tyrosine kinase inhibitors (TKIs) are indicated for the treatment of locally advanced or metastatic progressive thyroid carcinoma (CDT), refractory to radioactive iodine. The following report describes the efficacy of lenvatinib administered through a nose-gastric tube (SNG) in a patient affected with a poorly differentiated thyroid carcinoma (PDTC) which determined a stenosis of the esophagus. Material and Methods. A patient was followed up for papillary thyroid carcinoma follicular variant (T3NxMx), subjected to total thyroidectomy and treated with iodine-131 radio metabolic therapy. Two years after surgery, following the onset of dysphonia and dysphagia, patient was submitted to a computed tomography (CT) scan of the neck that showed the presence of a lesion of 6 × 2.5 × 3.5 cm, which determined trachea deviation and cervical esophagus compression. The biopsy indicated the presence of PDTC, triggering tracheal lumen reduction and sub-stenosis of the cervical esophagus for an ab-extrinsic compression. A nose-gastric tube (SNG) was placed and lenvatinib was started at a dose of 20 mg/day, administered via this probe after opening the capsules and diluting the drug in 10 ml of saline solution. Results. One month later, CT showed a significant cervical lesion reduction. Bronchoscopy confirmed tracheal infiltration, but the residual caliber was improved from 50% to 75%. At the esophagogastroduodenoscopy (EGDS), the sub stenosis of the cervical esophagus was no longer appreciated; however, a double perforation of the esophagus was found, without fistula. Conclusion. Lenvatinib therapy is effective also when administered via SNG. Our result is of particular relevance in the management of thyroid cancer patients, especially in the presence of subjects unable to swallow. Further studies are needed to validate the administration of lenvatinib by SNG, in order to extend the indications to this alternative administration way, beside the oral one.

scholarly journals Real-World Data for Lenvatinib in Radioiodine-Refractory Differentiated Thyroid Cancer (RELEVANT): A Retrospective Multicentric Analysis of Clinical Practice in Austria

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
G. Rendl ◽  
B. Sipos ◽  
A. Becherer ◽  
S. Sorko ◽  
C. Trummer ◽  
...  
Keyword(s):  
Overall Survival ◽  
Thyroid Cancer ◽  
Progression Free Survival ◽  
Duration Of Treatment ◽  
Real World Data ◽  
Free Survival ◽  
Proven Efficacy ◽  
Grade 3 ◽  
Dose Reductions ◽  
Retrospective Multicenter Study

Background. Lenvatinib has proven efficacy in progressive, radioiodine- (RAI-) refractory thyroid cancer (TC). Dose reductions are commonly performed due to decreased tolerability and adverse effects. This retrospective multicenter study analyzed overall survival (OS) and progression-free survival (PFS) and tolerability in the Austrian patient population treated with lenvatinib. Methods. Clinical data of 43 patients (25 males and 18 females) with a median age of 70 years (range: 39–91 years) and RAI-refractory TC with metastases to the lymph nodes (74%), lungs (86%), bone (35%), liver (16%), and brain (12%) were analyzed. The mean duration of treatment with lenvatinib was 26.6 ± 15.4 months with dosage reductions required in 39 patients (91%). Results. PFS after 24 months was 71% (95% CI: 56–87), and overall survival (OS) was 74% (95% CI: 60–88), respectively. OS was significantly shorter ( p = 0.048 ) in patients with a daily maintenance dosage ≤ 10 mg (63%) (95% CI: 39–86) as compared to patients on ≥ 14 mg lenvatinib (82%) (95% CI: 66–98) daily. Dose reduction was noted in 39 patients (91%). Grade ≥3 toxicities (hypertension, diarrhea, weight loss, and palmar-plantar erythrodysesthesia syndrome) were most common leading to discontinuation of lenvatinib in 7 patients (16%). Conclusion. Lenvatinib showed sustained clinical efficacy in patients with metastatic RAI-refractory TC even with reduced maintenance dosages over years. The effects were comparable to the registration trial, although patients had a higher median age and, more commonly, dose reductions.

Impact of a pre- and postoperative chemotherapy (Ctx) on overall survival (OS) and progression free survival (PFS) in locally advanced gastric cancer (LAGC).

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 156-156
Author(s):  
Ricarda Manth ◽  
H Schaefer ◽  
J Schroeder ◽  
G Spiessl ◽  
N Nuessler ◽  
...  
Keyword(s):  
Internal Control ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
Initial Therapy ◽  
Tumor Board ◽  
Free Survival ◽  
Locally Advanced Gastric Cancer ◽  
Primary Surgery ◽  
Secondary Endpoints

156 Background: Perioperative Ctx has become standard of care for LAGC. Duration of pre- and post-op Ctx is a matter of debate. Our study evaluated effects of varying durations of pre- and post-op Ctx on PFS and OS. Secondary endpoints were toxicity, reasons for cessation of Ctx and response. We compared the outcome to a group of pts receiving no perioperative Ctx as an internal control. Methods: Pts with LAGC were included in a prospective cohort trial from a single institution from 2007 to 2015. Inclusion criteria were T1-T4, N0-3, M0, AEG (n=27) or gastric cancers (n=65). Initial therapy decisions were made by an interdisciplinary tumor board for all pts. Pts received DDP/5-FU (qw d28 mod FFCD-Protocol, Ychou et al. JCO 2011) for 2 mo, and a 3rd mo of pre-op Ctx in case of non-progression after 2 mo and proceeded to Ctx after surgery for a planned total of six mo of Ctx. Results: 92 pts (53 m; 39 f pts) with a median age of 69 ys (range 33-96) were included. A total of 74 pts were recommended periop Ctx and 18 primary surgery (S). A total of 67 (91%) of the periop Ctx received pre-op Ctx (NA) of which 47 (64%) received 3 mo of pre-op Ctx, 19 (26%) two mo, 1 pt (1%) one mo, and 7 pts refused preop Ctx (9%) of which only 3 proceeded to surgery. Only 53 pts (72 %) received post-op Ctx; 25 pts (34%) received three mo, 9 pts (12 %) two mo, and another 10 pts (14 %) one mo of postop Ctx. Nine pts (13%) in the NA group and 20 pts (39%) in the post-op Ctx group had to stop Ctx due to toxicity after 1 (n=11) and <2 (n=9) mo of Ctx. Only 23 pts (31%) received the planned pre- and postop Ctx of 6 mo in total. Up to 07/2016 a total of 36 deaths were observed (39%). 5 yr PFS was 49% in the group of periop Ctx vs 14% in the S group. PFS in pts receiving a total of < 4 mo of Ctx was 36% vs. 61% in pts receiving 6 mo of Ctx. 3 yr OS was 19% in the S group vs 48% in the Ctx group. The OS in pts receiving < 4 mo was 34% vs.43% in pts with 6 mo Ctx. A pCR after preop Ctx was observed in 2 pts, a PR in 47 pts, a SD in 12 pts, while a PD occurred in 3 pts only. Conclusions: Pre-op Ctx was considerably better tolerated than post-op Ctx and led to fewer Tx cessations. We found a better PFS for pts with >4 mo of periop Ctx, as well as OS was affected by a shorter duration of periop Ctx.

scholarly journals Beneficial effects of sorafenib on tumor progression, but not on radioiodine uptake, in patients with differentiated thyroid carcinoma

2009 ◽  
Vol 161 (6) ◽  
pp. 923-931 ◽  
Author(s):  
Hendrieke Hoftijzer ◽  
Karen A Heemstra ◽  
Hans Morreau ◽  
Marcel P Stokkel ◽  
Eleonora P Corssmit ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Bone Metastases ◽  
Tumor Progression ◽  
Kinase Inhibitor ◽  
Treatment Options ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Mutational Status

ObjectiveTreatment options for patients with radioactive iodine (RaI) refractory metastases of differentiated thyroid carcinoma (DTC) are limited. We studied the effects of the multitarget tyrosine kinase inhibitor sorafenib on the reinduction of RaI uptake and tumor progression.DesignOpen, single center, single arm 26-week prospective phase II study with open-ended extension.MethodsWe treated 31 patients with progressive metastatic or locally advanced RaI refractory DTC with sorafenib 400 mg b.i.d. The primary endpoint was reinduction of RaI uptake at 26 weeks. Additional endpoints were the radiological response and the influence of bone metastases.ResultsAt 26 weeks of sorafenib therapy, no reinduction of RaI uptake at metastatic sites was observed, but 19 patients (59%) had a clinical beneficial response, eight of whom had a partial response (25%) and 11 had stable disease (34%). Seven patients had progressive disease (22%). Sorafenib was significantly less effective in patients with bone metastases. The estimated median progression free survival was 58 weeks (95% confidence interval, CI, 47–68). In general, thyroglobulin (Tg) response (both unstimulated and TSH stimulated) reflected radiological responses. The median time of the nadir of Tg levels was 3 months. Responses were not influenced by histological subtype, mutational status or other variables. No unusual side effects were observed.ConclusionsSorafenib has a beneficial effect on tumor progression in patients with metastatic DTC, but was less effective in patients with bone metastases. Diagnostic whole body scintigraphy did not reveal an effect of sorafenib on the reinduction of RaI uptake.

scholarly journals Análisis crítico de la literatura. ¿En pacientes adultos con cáncer diferenciado de tiroides y progresión en los últimos 14 meses, el tratamiento con sorafenib comparado con placebo mejora la supervivencia? Estudio DECISION

2017 ◽  
Vol 2 (3) ◽  
pp. 30-34
Author(s):  
Alejandro Román González ◽  
Álvaro Sanabria
Keyword(s):  
Thyroid Carcinoma ◽  
Radioactive Iodine ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Phase 3 ◽  
Double Blind ◽  
Free Survival ◽  
Poorly Differentiate ◽  
Sorafenib Group ◽  
Bayer Healthcare

Introducción: El carcinoma de tiroides es el cáncer endocrino más frecuente. Las opciones terapéuticas cuando hay enfermedad progresiva, sintomática y resistente al yodo radioactivo son mínimas y poco efectivas. El sorafenib es una terapia aprobada para estos pacientes con base en los resultados del estudio DECISION. Se hace una revisión crítica acorde con los principios de medicina basada en la evidencia del estudio que llevó a la aprobación de este medicamento.Título del estudio: Sorafenib in radioactive iodine-refractory, locally advanced or metastatic differentiated thyroid cancer: a randomised, double-blind, phase 3 trial. Lancet. 2014;384(9940):319-28 (1)Métodos: Ensayo clínico aleatorizado, financiado por Bayer HealthCare Pharmaceuticals y Onyx Pharmaceuticals, asignación oculta. Pacientes y resultados: 419 pacientes mayores de 18 años con cáncer de tiroides localmente avanzado o cáncer de tiroides diferenciado metastásico refractario a yodo (papilar, folicular, incluyendo el de células de Hürthle y pobremente diferenciado), con progresión en los últimos 14 meses de acuerdo con los criterios de RECIST, al menos una lesión medible por TAC o por RM, ECOG 0–2; con función renal, medular y hepática normal y TSH menor de 0,5 mIU/L. El cáncer de tiroides refractario a yodo se definió como la presencia de al menos una lesión sin captación de yodo o pacientes con tumores yodo captantes y, bien sea, progresión luego de un tratamiento con yodo radioactivo en los últimos 16 meses o progresión luego de dos tratamientos con yodo recibidos con menos de 16 meses de diferencia (la última dosis recibida más de 16 meses antes) o una dosis acumulada de yodo de al menos 22,3 GBq (?600 mCi). Se excluyeron pacientes que habían recibido previamente terapia dirigida, talidomida o quimioterapia para cáncer de tiroides, cirugía previa o trauma en los 30 días previos al inicio del medicamento, antecedente de cáncer de piel, cérvix o vejiga en los últimos cinco años, cáncer indiferenciado de tiroides, úlceras, infección activa o sangrado en los últimos tres meses, historia de hemorragia, infiltración traqueal, bronquial o esofágica; cardiopatía o hipertensión arterial no controlada, infección por VIH o hepatitis, embarazo o lactancia y alergia al sorafenib. Se permitieron dosis bajas de quimioterapia para radiosensibilización. El desenlace primario fue la supervivencia libre de progresión (cada ocho semanas) con criterios RECIST y los secundarios fueron supervivencia global, tiempo para la progresión, tasa de respuesta objetiva (parcial o completa), tasa de control de la enfermedad (parcial, completa o estable ?4 semanas/6 meses) y duración de la respuesta. La supervivencia libre de progresión fue mayor en el grupo de sorafenib que en el grupo de placebo (10,8 meses vs. 5,8 meses, HR 0,59 – IC 95% 0,45-0,76 p<0,0001). El grupo de sorafenib tuvo una mayor tasa de eventos adversos (98,6 vs. 87,6%).Conclusión: Sorafenib mejora significativamente la supervivencia libre de progresión comparado con placebo en pacientes con cáncer de tiroides diferenciado progresivo refractario a yodo radioactivo. La diferencia es pequeña. Los eventos adversos son frecuentes. No se reporta calidad de vida o mejoría sintomática. Esta terapia debe ser usada por personas expertas y debe evaluarse individualmente cada caso, agotando las opciones disponibles para el paciente antes de someterlo a los riegos del tratamiento.Abstract Introduction: Thyroid carcinoma is the most frequent endocrine cancer. There are minimal therapeutic options once the disease is metastatic, progressive, symptomatic and radioactive iodine resistant. Sorafenib is a recent approved therapy for these patients based on the results of the DECISION trial. A critical review of this study is done according to the principles of evidence-based medicine.Title of the study: Sorafenib in radioactive iodine-refractory, locally advanced or metastatic differentiated thyroid cancer: a randomised, double-blind, phase 3 trial. Lancet. 2014;384(9940):319-28(1)Methods: Randomized clinical trial. Financial support was by Bayer HealthCare Pharmaceuticals and Onyx Pharmaceuticals. Blinded randomization.Patients and results: 419 patients older tan 18 years with locally advanced thyroid carcinoma or well differentiate or poorly differentiate radioactive resistant metastatic thyroid carcinoma (papillary, follicular, Hurthle´s cell carcinoma and poorly differentiate), with progression over previous 14 months according to RECIST, with at least on measurable target lesion by CT or MR imaging, ECOG 0–2; normal kidney, medullar and liver function and TSH less than 0.5 mIU/L. Resistant radio-active iodine thyroid carcinoma was defined as the presence of at least 1 lesion without iodine uptake or patients with iodine uptake and progression over previous 16 months or progression after two cycles of radio-active iodine with less than 16 months of difference (lass cycle should be administered more 16 months before) or an total radioactive iodine of ?600 mCi. Patients who were treated before with target therapy, talidomide or systemic chemotherapy were excluded. Also patients with surgery or trauma 30 days before starting sorafenib, personal history of skin, cervical or bladder cancer, undifferentiated thyroid carcinoma, ulcers, active infection or bleeding in previous three months, bleeding history, tracheal, bronchial or esophageal infiltration, cardiomyopathy, uncontrolled high blood pressure, HIV infection, hepatitis, pregnancy or breast feeding and sorafenib allergy were excluded. Small chemotherapy doses for radio sensitization were allowed. Primary outcome was progression free survival (every 8 weeks) according to RECIST and secondary outcomes was overall survival, time to progression, rate of objective response (partial or complete), rate of disease control (partial, complete or stable) and response duration. Progression free survival was larger in the sorafenib group than in the placebo group (10.8 month vs5.8 months, HR 0.59 – IC 95% 0.45-0.76 p<0.0001). Sorafenib group had a higher side effects frequency (98·6 vs 87·6%). Conclusion: Sorafenib significantly improves progression free survival compared with placebo in patients with radio-active iodine resistant progressive thyroid carcinoma. The difference is small. Side effects are frequent and quality of life and symptomatic improvement are not reported. This therapy must be used by experts and an individual assessment must be done and all available options must be used before consider the use of this treatment.

scholarly journals Rationale and design of a phase II trial of durvalumab treatment in patients with NSCLC ineligible for stage III chemoradiotherapy following radiation monotherapy (SPIRAL-RT study)

2020 ◽  
Vol 12 ◽  
pp. 175883592092784 ◽  
Author(s):  
Tadaaki Yamada ◽  
Junji Uchino ◽  
Yusuke Chihara ◽  
Takayuki Shimamoto ◽  
Masahiro Iwasaku ◽  
...  
Keyword(s):  
Phase Ii ◽  
Antitumor Agents ◽  
Phase Ii Trial ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Stage Iii ◽  
Open Label ◽  
Free Survival ◽  
The Pacific ◽  
Secondary Endpoints

Background: In the PACIFIC study, progression-free survival (PFS) and overall survival (OS) of patients with unresectable, locally advanced, stage III non-small cell lung cancer (NSCLC) were prolonged by durvalumab as maintenance therapy after radical concurrent chemoradiotherapy using platinum-based antitumor agents. However, no data were obtained to reveal the efficacy of durvalumab after radiation monotherapy in patients unsuitable for chemoradiotherapy. Here, we describe an ongoing single-arm, prospective, open-label, multicenter phase II trial of durvalumab in patients with NSCLC ineligible for stage III chemoradiotherapy following radiation monotherapy (SPIRAL-RT study). Methods: Durvalumab at 10 mg/kg body weight is administered every 2 weeks after radiation therapy until individual patients meet the discontinuation criteria. The treatment duration is up to 12 months. The primary endpoint is the 1-year PFS rate. Secondary endpoints are response rate, PFS, OS, and safety. Durvalumab treatment after radiation monotherapy is expected to prolong 1-year PFS rate and have acceptable adverse events. Discussion: We are conducting an intervention study to investigate the safety and efficacy of durvalumab treatment in patients with NSCLC ineligible for stage III chemoradiotherapy following radiation monotherapy.

scholarly journals Efficacy and safety of lenvatinib in an elderly patient with metastatic papillary thyroid carcinoma and cardiological comorbidity: a case report

2019 ◽  
Vol 15 (24s) ◽  
pp. 27-33 ◽  
Author(s):  
Agnese Latorre ◽  
Agnese Maria Fioretti ◽  
Francesco Giotta ◽  
Vito Lorusso
Keyword(s):  
Atrial Fibrillation ◽  
Thyroid Carcinoma ◽  
Progression Free Survival ◽  
Chronic Atrial Fibrillation ◽  
Differentiated Thyroid Carcinoma ◽  
Phase Iii ◽  
Efficacy And Safety ◽  
Papillary Thyroid ◽  
Free Survival ◽  
Select Trial

Lenvatinib significantly prolonged progression-free survival versus placebo in patients with radio-iodine refractory differentiated thyroid carcinoma. However, the primary adverse effects of any grade that occurred in >40% of patients in the lenvatinib group of the Phase III SELECT trial was hypertension (67.8%). Therefore, this drug should be used with caution in patients with cardiological morbidity. Here, we describe the case of a 73-year-old man with hypertension, obesity and chronic atrial fibrillation, who received lenvatinib for 6 months in the absence of cardiological symptoms.

scholarly journals The surgical management of locally advanced well-differentiated thyroid carcinoma: changes over the years according to the AJCC 8th edition Cancer Staging Manual

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Alessio Metere ◽  
Valerio Aceti ◽  
Laura Giacomelli
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Surgical Management ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Cancer Staging ◽  
Differentiated Thyroid Carcinoma ◽  
Main Body ◽  
Well Differentiated ◽  
8Th Edition

Abstract Background Well-differentiated thyroid carcinoma is defined as locally advanced in the presence of an extra thyroid extension, e.g., when the surrounding structures such as the trachea, larynx, esophagus and main blood vessels are invaded by cancer. The 8th edition AJCC Cancer Staging Manual states that this is the main characteristic to evaluate for the staging and consequently for the prognosis in patients over 55 years old. Main body Distinguishing different forms of locally advanced thyroid cancer is essential, and the various anatomical structures and the clinical and therapeutic consequences must be taken into account. An accurate diagnosis of the organs invaded by thyroid cancer is necessary for the planning of surgical treatment, and both aspects are crucial to improving the patients’ survival. Patients affected by thyroid cancer with extra thyroid extension have a poor prognosis and the removal of the entire neoplasm represents a key factor for better disease-free survival. Conclusions We discuss the changes introduced by the 8th edition AJCC Cancer Staging Manual, in terms of the diagnostic and surgical management of extra thyroid extension, in patients affected by papillary and follicular thyroid cancer.

scholarly journals MON-LB76 Impact of Age on Survival and Prognostic Factors in Radioiodine Refractory Differentiated Thyroid Cancer Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Camille Buffet
Keyword(s):  
Thyroid Cancer ◽  
Prognostic Factors ◽  
Differentiated Thyroid Cancer ◽  
Kinase Inhibitors ◽  
Progression Free Survival ◽  
Therapeutic Management ◽  
Duration Of Treatment ◽  
Free Survival ◽  
Secondary Endpoints ◽  
Systemic Therapies

Abstract BACKGROUND Age has been identified as a major prognostic factor in differentiated thyroid cancer (DTC). Prognostic factors of radioiodine-refractory differentiated thyroid cancer (RAIR-DTC) are poorly described. The objectives of our study were to analyze the influence of age on the survival of patients with RAIR-DTC and to determine their prognostic factors according to age. PATIENTS AND METHOD This single centre, retrospective study enrolled 155 patients diagnosed with a RAIR-DTC between 1991 and 2017. The primary end point was overall survival (OS). Secondary endpoints were progression free survival (PFS) and prognostic factors. RESULTS Median OS was 8.2 years (95% IC: 5.3-9.6). There was no difference according to age (P = 0.47) with median OS at 8.3 years in patients &lt; 65 (95% IC: 4.9-10), and 7.5 years in patients &gt; 65 (IC: 4,9-11,3). PFS after RAIR-diagnosis was 2.1 years (95% IC: 0.8-3) in patients &lt; 65, and 1 year in patients &gt; 65 (95% IC: 0.34-0.68). In both groups, progressive disease despite 131I reduced OS, in comparison with other RAIR criteria. In patients &lt; 65, an interval between the initial diagnosis of DTC and the diagnosis of RAIR metastatic disease more than 3 years was protective from poor OS (HR: 2.12; 95% CI: 1.05-4.27). In patients &gt; 65, presence of a mediastinum metastasis at RAIR-diagnosis was a significant factor for decreased OS (HR: 0.22; 95% CI: 0.11-0.44). No difference was found between groups regarding therapeutic management. One third of patients received tyrosine kinase inhibitors in both groups (&lt; 65 years: 20 patients (28%), ≥ 65 years: 28 (33%), P = 0.49). They were also similar regarding the number of lines received or the median duration of treatment (&lt; 65 years: 19.5 months (2-59), ≥ 65 years: 19 months (1-64), p= 0.35). At least one line of TKI was transitorily or definitively withdrawn due to toxicity in 40% of patients (&lt; 65 years: 8/20 patients (40%), ≥ 65 years: 13/28 (46%), p= 0,037). CONCLUSION In RAIR-DTC patients, age was not predictive of the outcome. In our study, older patients seem to have benefited from intensive therapeutic management. Continual progress made in the management of RAIR-DTC, especially with the implementation of systemic therapies should probably make reconsider the natural history and conventional prognostic factors of RAIR-DTC.

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