Anlotinib has significant survival benefits and a favorable safety profile in patients with medullary thyroid carcinoma (MTC) who are older and have bone metastasis, according to a subanalysis of data from a phase 2b clinical trial published in the journal Frontiers in Oncology. These findings support the feasibility of anlotinib treatment in these patients. 

The clinical trial called ALTER01031 was a randomized, double-blind, placebo-controlled, multicenter study evaluating the safety and efficacy of anlotinib in locally advanced or metastatic MTC. It included a total of 91 patients, ages 18 to 70 at 19 locations across China. It started in July 2015 and was completed on September 30, 2018.

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In the present analysis, a team of researchers led by Xiangqian Zheng evaluated the safety and efficacy of the treatment in a subset of older patients (at least 50 years of age) and those with bone metastases.

The results showed that the median progression-free survival of older patients was 6.8 months and that of patients with bone metastasis was 7 months when given a placebo, suggesting a rapid progression of the disease. 

Anlotinib treatment significantly improved the median progression-free survival to 17.5 months and 20.7 months in older patients and patients with bone metastasis respectively. 

A significant benefit of anlotinib treatment in overall survival was also observed in older patients after a longer follow-up. 

The safety profile of the treatment in these patients was similar to that of the whole population.

MTC is a rare type of neuroendocrine tumor affecting the thyroid gland. It accounts for around 13.4% of disease-specific mortalities. The only curative treatment available for MTC is surgery but this is not sufficient in patients with metastatic disease. There are also a number of experimental drug treatments being developed for the disease.


Zhao J, Chi Y, Hu C, et al. Anlotinib in patients with medullary thyroid carcinoma with negative prognostic factors: A sub-analysis based on the ALTER01031 study. Front Oncol. Published online November 26, 2022. doi:10.3389/fonc.2022.852032

Study of Anlotinib in Patients With Medullary Thyroid Carcinoma(ALTER01031). US National Library of Medicine. Last updated May 21, 2019. Accessed December 16, 2022.