Outcomes of thyrotropin alfa vs. levothyroxine withdrawal-aided radioiodine therapy for distant metastasis of papillary thyroid cancer

xlomafota13 shared this article with you from Inoreader Outcomes of thyrotropin alfa vs. levothyroxine withdrawal-aided radioiodine therapy for distant metastasis of papillary thyroid cancer Via radioactive iodine Thyroid. 2021 Jun 22. doi: 10.1089/thy.2021.0013. Online ahead of print. ABSTRACT BACKGROUND: Thyrotropin alfa (rhTSH) is not currently approved by the Food and Drug Administration or European Medicines Agency for the preparation of radioactive iodine therapy (RAIT) in patients with distant metastatic papillary thyroid cancer (PTC). There are only a few studies comparing rhTSH with levothyroxine withdrawal (LTW) in this context. Our main aim was to compare the two methods of RAIT p reparation in terms of avidity and structural/biochemical response in distant metastatic PTC. We also intended to evaluate whether the two methods of RAIT preparation represented independent prognostic factors for progression-free survival (PFS) and disease-specific survival (DSS) in this subset of patients. METHODS: We performed a retrospective analysis of all patients with PTC treated with RAIT for distant metastatic disease between 2006-2018. We included 95 PTC patients - 27 (28.4%) had LTW and 68 (71.6%) had rhTSH for RAIT. RESULTS: The two groups presented similar clinicopathological characteristics, except for median age at PTC diagnosis which was higher in the rhTSH group (p=0.001), but the median age at first RAIT for distant metastatic disease was not different between the two methods of preparation, 63 years old [interquartile range (IQR) 23] in LTW group vs. 70 (IQR 26.75), p=0.06. Avidity was similar between the two groups (p=0.973). Median estimate PFS (p=0. 076) and DSS (p=0.084) were also similar between LTW and rhTSH. Regarding RAIT-related side effects, only 1 (3.7%) patient and 5 (7.4%) patients in the LTW and rhTSH groups, respectively, reported sialadenitis (p=0.670). CONCLUSIONS: There were no differences between the two methods of RAIT preparation regarding avidity and clinical response. rhTSH may be used as an alternative method of preparation for RAIT in patients with known distant lesions, as it presents similar clinical outcomes to LTW and a good safety profile. PMID:34155923 | DOI:10.1089/thy.2021.0013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.