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Nexavar for Neoadjuvant Treatment of Anaplastic Thyroid Cancer

Phase 2
Completed
Conditions
Thyroid Cancer, Anaplastic
Interventions
Procedure: operation
Radiation: External radiation therapy
Registration Number
NCT03565536
Lead Sponsor
Fujian Medical University
Brief Summary

Undifferentiated thyroid cancer is the most malignant tumor of the thyroid gland, with a median survival of only 3 months. Most undifferentiated cancers lose the chance of surgery when they are first diagnosed. The current study, Nexavar, is used only for dedifferentiated thyroid cancer and has not been applied to undifferentiated cancer. This study attempted to apply it to preoperative treatment of undifferentiated cancer to see if it would shrink the tumor and give the patient an opportunity for surgery.

Detailed Description

Undifferentiated thyroid cancer is the most malignant tumor of the thyroid gland, with a median survival of only 3 months. Most undifferentiated cancers lose the chance of surgery when they are first diagnosed. The current study, Nexavar, is used only for dedifferentiated thyroid cancer and has not been applied to undifferentiated cancer. This study attempted to apply it to preoperative treatment of undifferentiated cancer to see if it would shrink the tumor and give the patient an opportunity for surgery.

We chose patients with recurrent or inoperable anaplastic thyroid cancer and used NEXAVAR for 1 month of neoadjuvant therapy. If tumor lesions begin to resolve, they continue neoadjuvant therapy until the end of the second month. The total duration of preoperative treatment is two months.at the end of the second month, a CT scan was performed to assess whether surgery could be performed. If surgery is possible, NEXAVAR will continue to perform adjuvant radiotherapy after the surgery.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
18
Inclusion Criteria
  • Diagnosis of Undifferentiated or poorly differentiated thyroid cancer
  • Tumor invades the trachea, esophagus or common carotid artery that are Unresectable.
  • Locally recurrent anaplastic thyroid cancer
  • The lesion size is greater than 3cm
  • Patients in whom the oncologist has decide to start therapy with NEXAVAR.
Exclusion Criteria
  • Lesions cannot be evaluated by imaging
  • Synonymous with contraindications to Nexavar.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Nexavar neoadjuvant treatment groupNexavarAfter the patient had diagnosed as anaplastic thyroid cancer, Nexavar was used for neoadjuvant treatment. At 1 month and 2 months after treatment, it was assessed whether surgery could be performed. operation for possible surgical treatment,with complete thyroidectomy and cervical lymph node dissection are performed to completely resect thyroid tissue and metastatic lymphatic tissue. then External radiation therapy after surgery.
Nexavar neoadjuvant treatment groupExternal radiation therapyAfter the patient had diagnosed as anaplastic thyroid cancer, Nexavar was used for neoadjuvant treatment. At 1 month and 2 months after treatment, it was assessed whether surgery could be performed. operation for possible surgical treatment,with complete thyroidectomy and cervical lymph node dissection are performed to completely resect thyroid tissue and metastatic lymphatic tissue. then External radiation therapy after surgery.
Nexavar neoadjuvant treatment groupoperationAfter the patient had diagnosed as anaplastic thyroid cancer, Nexavar was used for neoadjuvant treatment. At 1 month and 2 months after treatment, it was assessed whether surgery could be performed. operation for possible surgical treatment,with complete thyroidectomy and cervical lymph node dissection are performed to completely resect thyroid tissue and metastatic lymphatic tissue. then External radiation therapy after surgery.
Primary Outcome Measures
NameTimeMethod
ThyroglobulinChange from Baseline Blood Thyroglobulin at 1 month, 2 months, 3 months after treatment with NEXAVAR

Thyroglobulin

Length of contact surface between tumor and common carotid arteryChange from Baseline Blood Thyroglobulin at 1 month, 2 months, 3 months after treatment with NEXAVAR

Length of contact surface between tumor and common carotid artery

CT assessmentChange from Baseline Blood Thyroglobulin at 1 month, 2 months, 3 months after treatment with NEXAVAR

Maximum tumor diameter measured by CT

Percentage of patients in whom the actual dose of sorafenib equaled the planned dose6 months after treatment with NEXAVAR

Percentage of patients in whom the actual dose of sorafenib equaled the planned dose

MST12 months after treatment with NEXAVAR

Median Survival Time (MST) was defined as the duration from the date of patient recruited to the date of death from any cause

Secondary Outcome Measures
NameTimeMethod
ORR1 month, 2 months, 3 months after treatment with NEXAVAR

Overall Response Rate (ORR) was defined as the total of CR (Complete Response) and PR (Partial Response). CR and PR were assessed by independent reviewers according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. ORR evaluated in 1 to 3 months after treatment with NEXAVAR

TTP12 months after treatment with NEXAVAR

Time to Progression (TTP) was defined as the duration from the date of patient recruited to the first progress at any site or the date of death

Rate of III-IV grade adverse events12 months after treatment with NEXAVAR

Adverse events was evaluated during received protocol therapy according to CTCAE 4.03

Overall tolerability of treatment as measured by rate of adverse events3 months after treatment with NEXAVAR

Overall tolerability of treatment as measured by rate of adverse events

Trial Locations

Locations (1)

Fujian Medical University Union Hospital

🇨🇳

FuZhou, Fujian, China

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