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Clinical Trial: Cabozantinib Shows Promise as First Line Treatment for Refractory Differentiated Thyroid Cancer

Marcia S. Brose, MD, PhD, a renowned researcher and physician at Penn Otorhinolaryngology — Head and Neck Surgery is leading the way as the primary investigator on novel agent cabozantinib for the treatment of differentiated thyroid cancer (DTC). 

Currently, DTC patients are treated with radioactive iodine (RAI). Though effective for the majority of patients, ~15 percent of these patients have cancers that are resistant to this therapy. These RAI-refractory patients are currently left with few treatment options.

Dr. Brose with a patient
Dr. Marcia Brose with a patient

Dr. Brose shared data from her new trial showing that cabozantinib, a tyrosine kinase inhibitor (TKI), is effective in treating patients with pre-treated RAI-refractory metastatic disease and inhibits the activity of the kinases MET, AXL and RET, and VEGF, which have oncogenic properties in thyroid cancer. 

The new study shares data demonstrating that most treated patients experienced tumor shrinkage, with 54% of patients achieving a partial response — defined as a shrinkage greater than 30 percent. 

“Our trial shows that cabozantinib is an active agent for patients with RAI-refractory thyroid cancer and may be able to significantly improve the care of patients who are at this advanced stage of their disease,” Dr. Brose detailed. Dr. Brose also included that the data shows the need for a larger, multi-center study, stating that plans for which are already underway.

Previously, Dr. Brose also led the clinical trial that prompted the 2013 FDA-approval of Sorafenib for RAI-refractory metastatic differentiated thyroid cancer. Currently, the TKI inhibitors levantinib and sorafenib are approved in the setting of RAI-refractory thyroid cancer. The drugs are used sequentially, but patients eventually progress to a stage where further options are currently unavailable. Use of cabozantinib would enable new care options for these patients.

See Dr. Brose discuss both therapies in her presentation, Sorafenib and Lenvatinib for the Treatment of Progressive, RAI-­Refractory DTC

Dr. Brose will present the findings from this cabozantinib trial on Friday afternoon at the 2018 Multidisciplinary Head and Neck Cancers Symposium (1:40pm MST) in Scottsdale, Arizona.

Penn Otorhinolaryngology — Head and Neck Surgery 

Dr. Brose is Director, Center for Rare Cancers and Personalized Therapy. Learn more about Head and Neck Surgery at Penn Medicine. 

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The Penn Physician Blog is a resource for health care professionals featuring Penn Medicine physicians and their research, innovations, programs and events. 

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