Multimodal Prehabilitation in Radioactive Iodine-refractory Differentiated Thyroid Cancer Treated With Lenvatinib.

Abstract Purpose This study describes our clinical experience with lenvatinib for the treatment of radioactive iodine refractory differentiated thyroid cancer (RR-DTC) using a multimodal patient-centered prehabilitation multidisciplinary approach assessing its effectiveness and patient outcomes. Methods and design This is a retrospective observational real-life study of a consecutive series of RR-DTC patients treated with lenvatinib as first-line treatment at Germans Trias i Pujol University Hospital. Results Partial response was observed in 6 patients (46.1%), stable disease in 5 patients (38.5%) and disease progression in 2 patients (15.4%). PFS and OS were 16.3 and 17.9 months respectively. AEs occurred in all patients. The most common adverse event (AE) was fatigue (69%), followed by diarrhea (46%), hypertension (46%) and anorexia (38.3%). Weight loss was present in 30.7% of the patients and only 7.7% was grade 3. Conclusion In our experience, prehabilitation can be useful to decrease not only the incidence but the severity of important side effects such as weight loss, anorexia and hypertension. For these complex patients, a multidisciplinary team is useful for follow-up, treatment and prevention of possible AEs.