Clinical Response and Toxicities of TKLS in Advanced Medullary Thyroid Cancer: Systematic Review and Meta-Analysis

Abstract

Background and aim: Several randomized controlled trials (RCTs) have investigated the effectiveness of different
TKIs. However, these studies have not been able to provide conclusive results. The aim of this systematic review and
Meta-analysis was effectiveness and safety of different TKIs and toxicities of TKIs in patients with advanced or
metastatic thyroid cancer.
Methods: MEDLINE, PubMed, Cochrane Library, Embase, ISI, google scholar were used as electronic databases to
perform a systematic literature until 2019. A commercially available software program (Endnote X9) was used for
electronic title management. Searches were performed with keywords, “thyroid”, “cancer OR carcinoma OR
neoplasm”, “vandetanib OR motesanib OR lenvatinib OR sorafenib OR axitinib OR sunitinib OR imatinib OR
cabozantinib OR selumetinib OR pazopanib”, “tyrosine kinase inhibitor”, “VEGF inhibitor OR therapy OR target
therapy” “protein kinase inhibitor”.
Results: All trials investigated the OS of patients receiving TKI treatment. lenvatinib showed significantly higher OS
than control group. No significant difference in OS was observed between groups among the MTC patients. Except
of vandetanib, sorafenib, cabozantinib and lenvatinib had a significant better partial RRs than control, respectively.
Pooling result of all TKIs exhibited a significantly higher partial RR than did the control group.
Conclusions: these drugs is important to manage AEs efficiently and proactively, and determine if the drug is no
longer effective.