Randomised controlled trials are feasible in anaplastic thyroid cancer
Mené aux Etats-Unis entre 2014 et 2016 sur 71 patients atteints d'un cancer anaplasique de la thyroïde (52 % de femmes ; durée médiane de suivi : 2,9 ans), cet essai randomisé multicentrique de phase II évalue l'efficacité, du point de vue de la survie globale, et la toxicité de l'ajout de pazopanib à un traitement comportant une radiothérapie avec modulation d'intensité et du paclitaxel
Eric J Sherman and colleagues report the results of a randomised and controlled trial (RCT) on anaplastic thyroid cancer. The study randomly allocated patients with anaplastic thyroid cancer, naive to chemotherapy or cervico-mediastinal radiotherapy, to receive paclitaxel and pazopanib or placebo followed by paclitaxel and pazopanib or placebo plus intensity-modulated radiotherapy (IMRT). Randomisation was stratified by distant metastases status. The trial successfully randomised 89 patients, with a more rapid than planned recruitment. The primary endpoint was not met as no difference in overall survival was observed between the pazopanib and placebo arms. In a post-hoc analysis the authors found substantially improved survival in patients with anaplastic thyroid cancer without distant metastases treated in the pazopanib arm, but there was no significant difference.
The Lancet Oncology 2023