Multidisciplinary Team Management of Lenvatinib Therapy in Differentiated Thyroid Cancer: Real-World Long-Term Treatment Outcomes

Background: Lenvatinib demonstrates efficacy in radioiodine-refractory differentiated thyroid cancer (RR-DTC), but managing adverse events (AEs) remains challenging. This study evaluated real-world outcomes of lenvatinib therapy supervised by a multidisciplinary team without dedicated medical oncologists.

Methods: The study retrospectively analyzed 44 DTC patients treated with lenvatinib (June 2015–December 2023), divided into long-term (≥657 days, n = 22) and short-term (<657 days, n = 22) groups based on median treatment duration.

Results: The long-term group showed significantly superior objective response rate (95.5% vs. 27.3%, P < .001), overall survival, and progression-free survival. Grade 3 fatigue occurred more frequently in the short-term group (45.5% vs. 9.1%, P = .016), with earlier onset (47.0 vs. 206.5 days, P = .022), representing the leading cause of AE-related treatment discontinuation. The long-term group more frequently implemented planned drug holidays (40.9% vs. 13.6%) and dose escalation (63.6% vs. 18.2%, P = .005), which were associated with prolonged treatment continuation. Multidisciplinary management, including pharmacist-led monitoring and telephone consultations, facilitated early detection and appropriate management of AEs.

Conclusions: Early identification and proactive management of fatigue, the most critical treatment-limiting adverse event, were essential for sustaining long-term lenvatinib therapy in real-world practice. Multidisciplinary care provided a supportive framework for fatigue-oriented management, enabling prolonged treatment in regional healthcare settings without dedicated medical oncology specialists.

Cite this article as: Demachi T, Watanabe A, Kimura Y, et al. Multidisciplinary team management of lenvatinib therapy in differentiated thyroid cancer: real-world long-term treatment outcomes. Balkan ORL-HNS, 2026, 3, 0133, doi: 10.5152/bohns.2026.25133.