{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T01:11:19Z","timestamp":1784164279695,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Lenvatinib, a tyrosine kinase inhibitor, is approved for the treatment of radioiodine refractory differentiated thyroid cancer (RR\u2010DTC) at a dose of 24 mg\/day. Given its significant toxicity profile, the present study aimed to compare the safety and efficacy of initial low\u2010dose lenvatinib to that of higher starting doses in patients with RR\u2010DTC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included patients with RR\u2010DTC who were classified as: Group\u2010A: patients receiving 10mg\/day, and Group\u2010B: patients receiving \u2265\u200914mg\/day of lenvatinib as starting dose. Safety, radiological response (as per RECIST 1.1) and progression\u2010free survival (PFS) outcomes were analysed and compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 105 patients with RR\u2010DTC were included in this study (Group\u2010A: 60, Group\u2010B: 45). The study found that Group\u2010B experienced significantly higher rates of drug interruptions (68.9% vs 48.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.035) and dose reductions (60% vs 11.7%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) compared to Group\u2010A. Adverse events such as hand\u2010foot skin reaction (77.8% vs 58.3%), diarrhea (28.9% vs 11.7%), hepatotoxicity (33.3\u201340% vs 11.7\u201318.3%), and electrolyte imbalance (15.6% vs 3.3%) were also more frequent in Group\u2010B (<jats:italic>p<\/jats:italic>\u2010values\u2009&lt;\u20090.05). However, both groups showed similar objective response rates (47.1% vs 46.3%; <jats:italic>p<\/jats:italic>\u2009=\u20090.936) and comparable PFS outcomes (restricted mean survival time at 24 months: 22.8 vs 21.4 months, <jats:italic>p<\/jats:italic>\u2009=\u20090.128).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study suggests that starting with lower doses of lenvatinib, followed by dose escalation if tolerated, may offer a safer approach with significantly lower rates of drug interruptions and dose reductions, with comparable efficacy in RR\u2010DTC patients. Further validation by larger prospective trials is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.15214","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T08:01:03Z","timestamp":1738656063000},"page":"721-729","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Low\u2010Dose Versus High\u2010Dose Lenvatinib in Radioiodine Refractory Differentiated Thyroid Cancer\u2014A Real\u2010World Safety and Efficacy Analysis"],"prefix":"10.1111","volume":"102","author":[{"given":"Jeepalem Sai","family":"Moulika","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal Ramesh","family":"Chandekar","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine All India Institute of Medical Sciences  New Delhi 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