Table 4 Systemic Therapy Patterns Among Patients With Advanced Medullary Thyroid Cancer
All MTC Patients | Patients With RET-Mutant MTC | |||||||
|---|---|---|---|---|---|---|---|---|
First-line Therapy | Second-line Therapy | First-line Therapy | Second-line Therapy | |||||
Number of patients initiating treatment (N, %) | 203 | 100.0% | 49 | 100.0% | 45 | 100.0% | 13 | 100.0% |
Performance status at start of treatment a, (n, %) | 138 | 68.0% | 35 | 71.4% | 30 | 66.7% | 9 | 69.2% |
0 or 1 | 112 | 81.2% | 20 | 57.1% | 25 | 83.3% | 6 | 66.6% |
2–4 | 26 | 18.8% | 15 | 42.9% | 5 | 16.7% | 3 | 33.3% |
Time from advanced MTC diagnosis to first line of treatment and time between first and second line of treatment, among patients who discontinued first line of treatment (n, %) | 203 | 100.0% | 49 | 100.0% | 45 | 100.0% | 13 | 100.0% |
Mean (SD) | 1.9 (6.0) | 1.3 (2.8) | 1.0 (1.4) | 0.8 (0.8) | ||||
Median (IQR) | 0.5 (0.3–1.2) | 0.5 (0.3–0.7) | 0.5 (0.3–1.2) | 0.5 (0.3–1.2) | ||||
Total duration of therapy line, months (n) | 203 | 49 | 45 | 13 | ||||
Kaplan–Meier estimate | ||||||||
Median (95% CI) | 12.5 (9.2–18.2) | 7.9 (5.8–11.2) | 9.7 (6.6–23.7) | NE (6.1-NE) | ||||
Treatment ongoing (n, %) | 73 | 36.0% | 16 | 32.70% | 15 | 33.3% | 9 | 69.20% |
Number of patients who discontinued treatment (n, %) | 130 | 64.0% | 33 | 67.3% | 30 | 66.7% | 4 | 30.8% |
Reason for discontinuation (n, %) b, c | ||||||||
Adverse event | 3 | 2.3% | 0 | 0.0% | 1 | 3.3% | 0 | 0.0% |
Patient decision | 19 | 14.6% | 5 | 15.2% | 4 | 13.3% | 3 | 75.0% |
Progressive disease | 70 | 53.8% | 18 | 54.5% | 15 | 50.0% | 1 | 25.0% |
Completion of planned course of treatment | 43 | 33.1% | 9 | 27.3% | 11 | 36.7% | 1 | 25.0% |
Loss to follow-up | 3 | 2.3% | 0 | 0.0% | 0 | 0.0% | 0 | 0.0% |
Death | 9 | 6.9% | 2 | 6.1% | 2 | 6.7% | 0 | 0.0% |
Other: alternative treatment | 1 | 0.8% | 0 | 0.0% | 0 | 0.0% | 0 | 0.0% |
Unknown | 2 | 1.5% | 1 | 3.0% | 1 | 3.3% | 1 | 25.0% |
Reasons for not administering additional cancer-directed systemic treatment for advanced MTC, among patients with no subsequent treatment and patients who were alive at the time of discontinuing last line of treatment (n, %) b | 72 | 35.5% | 27 | 55.1% | 15 | 33.3% | 3 | 23.1% |
Patient decision | 21 | 29.2% | 6 | 22.2% | 2 | 13.3% | 1 | 33.3% |
Frail physical status | 16 | 22.2% | 1 | 3.7% | 2 | 13.3% | 0 | 0.0% |
Stable disease | 23 | 31.9% | 5 | 18.5% | 8 | 53.3% | 1 | 33.3% |