Targeted Therapies in Thyroid Cancer
Of all thyroid cancers diagnosed yearly worldwide >90 % are considered differentiated thyroid carcinomas (DTC), i.e. papillary or follicular cancers. The majority of patients with these cancers are rendered cured with an operation, radioactive iodine (RAI) ablation, and thyroid-stimulating hormone (TSH) suppression. Therapeutic goals in DTC are first to reduce cancer-specific mortality, second to diminish tumour recurrence, and third to minimize treatment-related morbidity. The mainstay of treatment has been adequate operative resection, typically in the form of a total thyroidectomy with clearance of suspicious or biopsy-positive adenopathy in the lateral and/or central neck compartments. Beyond surgical treatment, RAI and TSH suppression are used as adjuvant therapy for residual or recurrent cancer. Although the patient prognosis is typically good, 5–10 % of patients with an initial diagnosis of thyroid cancer will have tumours that dedifferentiate, resulting in widespread metastatic disease and/or the inability to capture iodine . Most of these patients will succumb to their cancer . For patients with progressive metastatic DTC that is neither surgically resectable nor treated effectively with RAI, treatment options have historically been limited. Cytotoxic chemotherapy with agents, such as doxorubicin, etoposide, taxanes and platinum compounds, has been used to treat patients with aggressive or progressive non-RAI-avid cancer, but such chemotherapy is associated with marginal clinical response rates and toxic side-effects .
KeywordsThyroid Cancer Vascular Endothelial Growth Factor Receptor Papillary Thyroid Cancer Medullary Thyroid Carcinoma Differentiate Thyroid Carcinoma
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