RTP On Demand — Head & Neck/Thyroid | Research To PracticeTrials combining everolimus and sorafenib in differentiated thyroid cancer
1:55 minutes.
TRANSCRIPTION:
DR COHEN: So the reason to think about an mTOR inhibitor is that we know that the PI3 kinase pathway can be activated in these cancers, usually by a genomic level alteration, PIK3CA mutation, TSC mutation and some others. And so the rationale is for them to combine it. And, of course, they can be combined fairly readily. There’s some toxicity associated, but certainly the combinations are feasible. And we did see 2 papers presented this year at ASCO doing exactly that. Both of them used sorafenib. Both of them used everolimus. The patient populations were a little bit different, slightly different. One paper enrolled a more refractory patient population. But suffice it to say, for both of those experiences, it does appear to have some promise, that the addition of an mTOR inhibitor — in this case, everolimus — to sorafenib does appear to improve efficacy, especially with respect to progression-free survival. Now, these were nonrandomized studies. And so it’s hard to make those definitive conclusions, but I think there’s enough promising data there to begin to explore this in future trials. Sorafenib is a drug that has efficacy in this disease. I think really the important elements are that it does improve progression-free survival. It does — I think we’re fairly convinced. I’m certainly convinced that it does change the natural history of the disease. And the paper presented augments, but I don’t think it really changed the way we perceive the drug that much. It is an effective drug, and I think we accept that. |