Hakan Kaya,Elif Peker,Erol Metecan Düren,
Neoadjuvant Target Therapy with Lenvatinib Followed by Reoperative Central Neck Surgery for Thyroid Cancer
Surgical Case Reports
2024
2613-5965
http://dx.doi.org/10.31487/j.SCR.2024.03.01
https://www.sciencerepository.org/neoadjuvant-target-therapy-with_SCR-2024-3-101 
Abstract: Thyroid cancer is the most common endocrine malignancy, with differentiated thyroid cancers, including papillary and follicular cancers, accounting for nearly 95% of cases. These cancers generally have an excellent prognosis. However, RAI (radioiodine)-refractory disease remains a significant challenge for clinicians. Lenvatinib, a potent multikinase inhibitor targeting vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor alpha, and RET and KIT proto-oncogenes, offers a potential treatment option. In this report, we present a case where lenvatinib was utilized in a neoadjuvant setting. The patient had a history of thyroidectomy and neck dissection. Follow-up revealed elevated thyroglobulin (Tg) levels, and physical examination and ultrasonography (US) identified lymphadenopathies in the central neck and strap muscles. Lenvatinib treatment resulted in a 50% reduction in lymphadenopathy size, but was temporarily discontinued due to hypertension, the most common adverse effect. Subsequently, all metastatic lymph nodes and involved strap muscles were successfully resected, with an uneventful postoperative period and no wound complications. As lenvatinib is a relatively new drug, data on its neoadjuvant use is limited.Keywords: Thyroid cancer, kinase inhibitors, RAI-refractory, lenvatinib, neoadjuvant therapy