{"entity":{"id":"paper-select-lenvatinib-nejm-2015","kind":"paper","name":"SELECT: lenvatinib versus placebo in radioiodine-refractory differentiated thyroid cancer","aka":[],"tldr":"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.\n\nMedian 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.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2015","url":"https://doi.org/10.1056/NEJMoa1406470"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/25671254/"}],"tags":[],"related":[],"cancers":["follicular-thyroid-cancer","papillary-thyroid-cancer"],"sections":[],"technologies":[],"targets":[],"drugs":["lenvatinib"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["select-lenvatinib"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2015,"doi":"10.1056/NEJMoa1406470","pmid":"25671254","authors":"Schlumberger M, Tahara M, Wirth LJ, et al.","paperType":"rct","findings":["Median progression-free survival 18.3 vs 3.6 months; hazard ratio 0.21.","Objective response 64.8 percent vs 1.5 percent."],"whatItMeans":"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."],"changedPractice":true,"participants":392},"route":"/key-papers/paper-select-lenvatinib-nejm-2015/","neighbours":{"cancer":[{"id":"follicular-thyroid-cancer","kind":"cancer","name":"Follicular thyroid cancer","route":"/cancers/follicular-thyroid-cancer/"},{"id":"papillary-thyroid-cancer","kind":"cancer","name":"Papillary thyroid cancer","route":"/cancers/papillary-thyroid-cancer/"}],"drug":[{"id":"lenvatinib","kind":"drug","name":"Lenvatinib","route":"/drugs/lenvatinib/"}],"trial":[{"id":"select-lenvatinib","kind":"trial","name":"SELECT","route":"/trials/select-lenvatinib/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}