CLINICAL TRIAL article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1587412
This article is part of the Research TopicAdvances in Management of Aggressive Thyroid Cancer: Medullary and Advanced Thyroid CancerView all 9 articles
Efficacy and Safety of Anlotinib Combined with ¹²⁵I Seed Implantation for Iodine-Refractory Thyroid Cancer
Provisionally accepted
- 1Department of Nuclear Medicine, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi Province, China
- 2Nanchang University, Nanchang, Jiangxi Province, China
- 3Department of Nuclear Medicine, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
- 4Department of Nuclear Medicine, Jiangxi Cancer Hospital, Nanchang, Jiangxi Province, China
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Background and Objective: Radioiodine-refractory differentiated thyroid cancer (RAIR-DTC) remains challenging to treat due to a lack of effective therapies. This study aimed to evaluate the efficacy and safety of combining anlotinib with iodine-125 (¹²⁵I) seed implantation in patients with RAIR-DTC. Methods and Materials: We retrospectively compared three treatment groups in 52 patients with advanced RAIR-DTC: anlotinib monotherapy (Group A, n = 14), ¹²⁵I seed brachytherapy monotherapy (Group B, n = 25), and combined therapy (Group C, n = 13). Clinical outcomes including local progression-free survival (LPFS), overall survival (OS), tumor response, serum thyroglobulin (Tg) levels, and adverse events were analyzed. Results: As of February 2025, the combination therapy group achieved a longer median LPFS (42.2 months) than either monotherapy group (18.6–18.7 months; p = 0.023) and a higher objective response rate at 6 months (77% vs. 21–32% with monotherapies; p < 0.05). Tumor volumes in all groups decreased after treatment, with the greatest reduction within 6 months in the combination group (p < 0.001). By 12 months, response differences between groups narrowed, and median OS was similar across groups (~22–43 months, p = 0.425). Serum Tg levels declined significantly from baseline in all groups. No major procedural complications occurred, and treatment-related adverse reactions were mostly mild (Grade 1–2) and comparable among groups. Conclusion: Combining ¹²⁵I seed brachytherapy with anlotinib demonstrated superior short-term tumor control and prolonged local disease remission in RAIR-DTC, without increasing toxicity. This combination may offer a promising therapeutic option for RAIR-DTC, pending further validation in larger studies.
Keywords: radioactive iodine-refractory thyroid cancer, Anlotinib, iodine-125 seed brachytherapy, combination therapy, Multikinase inhibitor, Progression-free survival
Received: 04 Mar 2025; Accepted: 31 Jul 2025.
Copyright: © 2025 Chen, Tang, Tan, Su, Wang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Liling Tan, Department of Nuclear Medicine, Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China
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