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Table 1 Phase II trials of sorafenib in DTC

From: Rationale and design of DECISION: a double-blind, randomized, placebo-controlled phase III trial evaluating the efficacy and safety of sorafenib in patients with locally advanced or metastatic radioactive iodine (RAI)-refractory, differentiated thyroid cancer

Trial

Efficacy Results

Grade ≥ 3 AEs in ≥ 5%

of Patients

Other

Single-arm trial

(N = 55 total;

n = 47 DTC) [10–12]

mPFS = 84 weeks*

SD = 53.3%†

PR = 23.3%†

DCR = 76.6%†

OS = 140 weeks†

Hypertension (13%), hand-foot syndrome (10%), rash (10%), weight loss (10%), diarrhea (7%), elevated LFTs (7%)‡

• Dose reduction (due to AEs) was required in 47% of patients (initial analysis)

• Median duration of treatment at initial analysis (30 of 55 patients accrued) = 27 weeks

• BRAF genotyping (n = 16): mPFS = 84+ weeks in DTC patients with BRAFV600E, compared with 54 weeks in those with BRAFwt (P = 0.028)

Single-arm component (chemotherapy-naive patients with DTC) of two-arm trial (N = 56 total; n = 41 DTC) [13]

mPFS = 65 weeks*

SD = 57%*

PR = 15%*

DCR = 72%*

Fatigue, HSFR (11% each); weight loss, skin rash, hypertension, diarrhea, stomatitis, tongue/tooth pain, abdominal/rectal pain, proximal myopathy, back pain, general pain, hand/foot pain, arthralgia, colon perforation (5% each)

• Dose reduction (due to AEs) was required in 52% of patients

Single-arm trial

(N = 26 total;

n = 14 DTC) [14, 15]

mPFS not reported

SD = 82%†

PR = 18%†

DCR = 100%†

Hand-foot syndrome (19%), other skin toxicity (6%),

hypertension (6%), infection (8%)

• Dose reduction (due to AEs) was required in 62% of patients

• Five drug-related serious AEs were reported:

2 hospitalizations for non-neutropenic fever/infection, 1 for hypocalcemia, and 2 for fever/rash

Single-arm trial

(N = 31; all DTC) [16]

mPFS = 58 weeks

SD = 34%

PR = 25%

DCR = 59%

HFSR (22%), hypertension (16%), weight loss (9%)

• Dose reduction (due to AEs) was required in 56% of patients

  1. *DTC cohort
  2. †Total study sample
  3. ‡One patient developed grade 3/4 LFT abnormalities at 8 weeks and died of liver failure 12 weeks later
  4. DTC = differentiated thyroid cancer; mPFS = median progression-free survival; SD = stable disease; PR = partial response;
  5. DCR = disease control rate; LFTs = liver function tests; HFSR = hand-foot skin reaction; AE = adverse event