Evolving molecularly targeted therapies for advanced-stage thyroid cancers

被引:65
作者
Bible, Keith C. [1 ,2 ]
Ryder, Mabel [1 ,2 ,3 ]
机构
[1] Mayo Clin, Div Med Oncol, Dept Oncol, Ctr Canc, Rochester, MN 55905 USA
[2] Mayo Clin, Endocrine Malignancies Dis Oriented Grp, Ctr Canc, Rochester, MN 55905 USA
[3] Mayo Clin, Div Endocrinol, Dept Med, 200 First St SW, Rochester, MN 55905 USA
关键词
ENDOTHELIAL GROWTH-FACTOR; TRANSFERASE INHIBITOR R115777; SODIUM-IODIDE SYMPORTER; HURTHLE CELL-CARCINOMA; PPAR-GAMMA AGONIST; DOUBLE-BLIND; PHASE-2; TRIAL; ASSOCIATION GUIDELINES; INCREASED EXPRESSION; UNITED-STATES;
D O I
10.1038/nrclinonc.2016.19
中图分类号
R73 [肿瘤学];
学科分类号
100214 [肿瘤学];
摘要
Increased understanding of disease-specific molecular targets of therapy has led to the regulatory approval of two drugs (vandetanib and cabozantinib) for the treatment of medullary thyroid cancer (MTC), and two agents (sorafenib and lenvatinib) for the treatment of radioactiveiodine refractory differentiated thyroid cancer (DTC) in both the USA and in the EU. The effects of these and other therapies on overall survival and quality of life among patients with thyroid cancer, however, remain to be more-clearly defined. When applied early in the disease course, intensive multimodality therapy seems to improve the survival outcomes of patients with anaplastic thyroid cancer (ATC), but salvage therapies for ATC are of uncertain benefit. Additional innovative, rationally designed therapeutic strategies are under active development both for patients with DTC and for patients with ATC, with multiple phase II and phase III randomized clinical trials currently ongoing. Continued effort is being made to identify further signalling pathways with potential therapeutic relevance in thyroid cancers, as well as to elaborate on the complex interactions between signalling pathways, with the intention of translating these discoveries into effective and personalized therapies. Herein, we summarize the progress made in molecular medicine for advanced-stage thyroid cancers of different histotypes, analyse how these developments have altered - and might further refine - patient care, and identify open questions for future research.
引用
收藏
页码:403 / 416
页数:14
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