Re: "Symptomatic Biliary Disorders During Lenvatinib Treatment For Thyroid Cancer: An Underestimated Problem" By Nervo Et Al.

This letter is to confirm and support the data of Nervo et al, recently published on Thyroid journal, and showing a relevant prevalence of biliary disorders in patients affected by advanced thyroid cancer (TC) and treated with lenvima. We also observed a similar prevalence of gallbladder and/or biliary disease in a bigger series of TC treated with lenvima: by combining the Nervo et al. and our data the prevalence of this adverse event is of 16/118 (13.5%) and it seems independent from the starting daily dose. Only few differences have been observed: in our series some patients developed the adverse event even several months of treatment although the median time of onset was 3 months, some patients were asymptomatic and the disease was discovered at CT scan, some patients completely recover after the daily dose reduction and did not need to be operated.