{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:15:45Z","timestamp":1791605745633,"version":"4.3.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The management of patients with locally advanced or metastatic differentiated thyroid cancer (DTC) that is refractory to radioiodine (RAI) remains a therapeutic challenge. The multi-tyrosine kinase inhibitors (TKIs) sorafenib and lenvatinib have been approved based on phase 3 clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>We aimed at describing the efficacy and safety of TKI treatment of RAI-refractory DTC in a real-world setting at six German referral centers. One hundred and one patients with locally advanced or metastatic RAI-refractory DTC treated with sorafenib, lenvatinib, and\/or pazopanib were included. Progression-free survival (PFS) and overall survival (OS) probabilities were estimated by using the Kaplan-Meier method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Ninety-seven of 101 patients had progressive disease before TKI initiation. The median PFS for first-line treatment with sorafenib (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200933), lenvatinib (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200953), and pazopanib (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200915) was 9 (95% confidence interval 5.2\u201312.8), 12 (4.4\u201319.6), and 12 months (4.4\u201319.6), respectively. The median OS for first-line treatment was 37 (10\u201364) for sorafenib, 47 (15.5\u201378.5) for lenvatinib, and 34 months (20.2\u201347.8) for pazopanib. Serious complications (e.g., hemorrhage, acute coronary syndrome, and thrombosis\/venous thromboembolism) occurred in 16 out of 75 (21%) patients taking lenvatinib, in 3 out of 42 (7%) patients taking sorafenib, and in 3 out of 24 (13%) patients taking pazopanib.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Sorafenib, lenvatinib, and pazopanib are effective treatment options in the majority of patients with RAI-refractory DTC. The PFS and six-month survival rate in patients treated with lenvatinib und pazopanib appear to compare favorably with sorafenib in the first-line treatment setting. However, a more advanced disease stage at treatment initiation in sorafenib- and pazopanib-treated patients in the era before TKI-approval and the retrospective nature of this study precludes a direct comparison of TKIs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2021.0091","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T05:05:48Z","timestamp":1629263148000},"page":"1531-1541","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Real-World Efficacy and Safety of Multi-Tyrosine Kinase Inhibitors in Radioiodine Refractory Thyroid Cancer"],"prefix":"10.1177","volume":"31","author":[{"given":"Viktoria Florentine","family":"Koehler","sequence":"first","affiliation":[{"name":"Department of Internal Medicine IV and University Hospital, LMU Munich, Munich, Germany."},{"name":"Department of Internal Medicine I, Goethe University Hospital, Frankfurt, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV and University Hospital, LMU Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Adam","sequence":"additional","affiliation":[{"name":"Division of Endocrinology\/Diabetology, Department of Internal Medicine I, University of W\u00fcrzburg, W\u00fcrzburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian-Luca","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Pfestroff","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Luster","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana Maria","family":"Kutsch","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"Lapa","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Sandner","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Nephrology and Rheumatology and Transplant-, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Rayes","sequence":"additional","affiliation":[{"name":"Department of Visceral-, Transplant-, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmina Teresa","family":"Fuss","sequence":"additional","affiliation":[{"name":"Division of Endocrinology\/Diabetology, Department of Internal Medicine I, University of W\u00fcrzburg, W\u00fcrzburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Kreissl","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Hoster","sequence":"additional","affiliation":[{"name":"Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Allelein","sequence":"additional","affiliation":[{"name":"Division for Specific Endocrinology, Medical Faculty, University of D\u00fcsseldorf, D\u00fcsseldorf, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Schott","sequence":"additional","affiliation":[{"name":"Division for Specific Endocrinology, Medical Faculty, University of D\u00fcsseldorf, D\u00fcsseldorf, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Todica","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Fassnacht","sequence":"additional","affiliation":[{"name":"Division of Endocrinology\/Diabetology, Department of Internal Medicine I, University of W\u00fcrzburg, W\u00fcrzburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7628-3161","authenticated-orcid":false,"given":"Matthias","family":"Kroiss","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV and University Hospital, LMU Munich, Munich, Germany."},{"name":"Division of Endocrinology\/Diabetology, Department of Internal Medicine I, University of W\u00fcrzburg, W\u00fcrzburg, Germany."},{"name":"Comprehensive Cancer Center Mainfranken, University of W\u00fcrzburg, W\u00fcrzburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Spitzweg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV and University Hospital, LMU Munich, Munich, Germany."},{"name":"Adjunct Academic Appointment, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, 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Consortium 2010 Efficacy of pazopanib in progressive, radioiodine-refractory, metastatic differentiated thyroid cancers: results of a phase 2 consortium study. Lancet Oncol, 11:962\u2013972.","journal-title":"Lancet Oncol"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-10-0994"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.9566"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28766"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0356"},{"key":"e_1_3_5_11_2","doi-asserted-by":"crossref","first-page":"e668","DOI":"10.1634\/theoncologist.2019-0633","article-title":"Clinicopathological features predict outcomes in patients with radioiodine-refractory differentiated thyroid cancer treated with sorafenib: a real-world study","volume":"25","author":"Cheng L","year":"2020","unstructured":"Cheng L, , Fu H, , Jin Y, , Sa R, , Chen L. 2020. 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