ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026
Real-world experience of clinicopathological features and survival predictors in radioactive iodine-refractory differentiated thyroid cancer treated with multi-kinase inhibitors: a multicentre study from southeastern Spain.
Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeReal-world evidence studies provide valuable information on clinical multi-kinase inhibitor (MKI) treatment approaches. Reported real-world (rw) progression-free-survival (rwPFS) and overall-survival (rwOS), and prognostic factors show considerable variability. We aimed to characterise clinicopathological features and identify prognostic factors of rwPFS and rwOS in patients with unresectable or metastatic radioactive iodine-refractory differentiated thyroid carcinoma (RAI-R DTC) treated with MKIs as part of routine clinical care across three medical centres in southeastern Spain.
methodsMulticentre retrospective observational study based on real-world data. We analysed rwPFS, rwOS, objective response rate (ORR), disease control rate (DCR), adverse events (AEs) and adjusted risk factors. Statistical analysis comprised descriptive statistics, Kaplan-Meier curves, log-rank tests and multivariable Cox regression.
resultsCohort of 58 patients. Median age at DTC diagnosis was 62.0 years, at metastasis diagnosis 67 years, and 55.2% were female. First-line MKIs comprised mostly sorafenib 55.2%, and lenvatinib 34.5%. Median follow-up was 37.13 (0.49-165.82) months. Median rwPFS and rwOS were 32.66 and 55.66 months, respectively. ORR, DCR and AEs grade (3-4) rate were 41.2%, 88.2%, and 25.9%, respectively. Age ≥ 67 years at metastasis diagnosis, AEs grade (3-4), and objective response were independent factors significantly associated with improved rwPFS whereas neutrophil-to-lymphocyte ratio (NLR) ≥ 3.5 was independently associated with shorter rwPFS and, in adjusted analysis, with shorter rwOS.
conclusionNLR ≥ 3.5 was independently associated with poorer rwPFS and, in adjusted analysis, with poorer rwOS, representing a low-cost candidate marker with potential utility to guide MKI therapy and patient selection that warrants prospective validation.
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