# SELECT: lenvatinib versus placebo in radioiodine-refractory differentiated thyroid cancer

Source: https://onco.cc/key-papers/paper-select-lenvatinib-nejm-2015/  
OnCo record `paper-select-lenvatinib-nejm-2015` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The multikinase inhibitor lenvatinib delayed progression by almost fifteen months compared with placebo in iodine-refractory differentiated thyroid cancer and shrank tumours in two thirds of patients, becoming the preferred drug for this disease.

## Summary

Phase 3 placebo-controlled trial of 392 patients with progressive radioiodine-refractory differentiated thyroid cancer randomised 2:1 to lenvatinib 24 mg daily or placebo.

Median progression-free survival was 18.3 versus 3.6 months (hazard ratio 0.21) and response 64.8 versus 1.5 percent; hypertension, diarrhoea, fatigue and proteinuria led to dose reductions in most patients, and there were six treatment-related deaths.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: New England Journal of Medicine
- Year: 2015
- DOI: 10.1056/NEJMoa1406470
- Authors: Schlumberger M, Tahara M, Wirth LJ, et al.
- Findings: Median progression-free survival 18.3 vs 3.6 months; hazard ratio 0.21.; Objective response 64.8 percent vs 1.5 percent.
- What it means: Lenvatinib is the first-choice kinase inhibitor for progressive iodine-refractory papillary and follicular thyroid cancer, reserved for symptomatic or rapidly progressing disease because of its toxicity.
- Caveats: No overall survival benefit because of crossover.; Starting dose debate; 18 mg was not non-inferior in a later study.

## Sources

- N Engl J Med 2015: https://doi.org/10.1056/NEJMoa1406470
- PubMed: https://pubmed.ncbi.nlm.nih.gov/25671254/

## Connected records

- cancers: [Follicular thyroid cancer](https://onco.cc/cancers/follicular-thyroid-cancer/), [Papillary thyroid cancer](https://onco.cc/cancers/papillary-thyroid-cancer/)
- drugs: [Lenvatinib](https://onco.cc/drugs/lenvatinib/)
- trials: [SELECT](https://onco.cc/trials/select-lenvatinib/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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