# DECISION: sorafenib in radioactive iodine-refractory differentiated thyroid cancer

Source: https://onco.cc/key-papers/paper-decision-sorafenib-lancet-2014/  
OnCo record `paper-decision-sorafenib-lancet-2014` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Sorafenib was the first drug shown to delay progression in iodine-refractory differentiated thyroid cancer, adding about five months compared with placebo and opening the era of kinase inhibitors for the disease.

## Summary

Phase 3 placebo-controlled trial of 417 patients with progressive radioactive iodine-refractory differentiated thyroid cancer randomised to sorafenib or placebo.

Median progression-free survival was 10.8 versus 5.8 months (hazard ratio 0.59) with response 12.2 versus 0.5 percent; hand-foot skin reaction, diarrhoea, alopecia and rash were common.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet
- Year: 2014
- DOI: 10.1016/S0140-6736(14)60421-9
- Authors: Brose MS, Nutting CM, Jarzab B, et al.
- Findings: Median progression-free survival 10.8 vs 5.8 months; hazard ratio 0.59.; Objective response 12.2 percent vs 0.5 percent.
- What it means: Sorafenib is an approved option for iodine-refractory thyroid cancer, now usually used after or instead of lenvatinib depending on tolerability.
- Caveats: No overall survival benefit; response rate low compared with lenvatinib.

## Sources

- Lancet 2014: https://doi.org/10.1016/S0140-6736(14)60421-9
- PubMed: https://pubmed.ncbi.nlm.nih.gov/24768112/

## Connected records

- cancers: [Follicular thyroid cancer](https://onco.cc/cancers/follicular-thyroid-cancer/)
- drugs: [Sorafenib](https://onco.cc/drugs/sorafenib/)
- trials: [DECISION](https://onco.cc/trials/decision-sorafenib/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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