New possibilities of systemic treatment of thyroid cancer

01/2018

MUDr. Kateřina Kopečková

Onkologická klinika 2. LF UK a FN v Motole, Praha

SUMMARY

Differentiated carcinomas represent 90% of all thyroid malignancies. Median survival in radioiodine-refractory carcinomas (10-20% of all tumors) is 2.5-3.5 years. New knowledge in the field of molecular genetics has been the basis for the development of new systemic drug therapies. Sorafenib, a multikinase inhibitor, is approved for the treatment of radioiodine-refractory differentiated carcinoma on the basis of a randomized placebo-controlled clinical trial in which a longer progression of the disease was achieved in patients treated with sorafenib for 5 months. The second new drug to be registered is lenvatinib with the same indication and time to disease progression of 18.3 months. Medullar carcinoma is a rare thyroid gland tumor. The first registered drug for this diagnosis is the multikinase inhibitor of vandetanib followed by cabozantinib. In the vandetanib registration study, median time to progression was not reached and estimated age based on statistical modeling was 30.5 months. The time to progression of the disease in the clinical trial with cabozantinib was 11.2 months compared to 4.0 months for placebo.

KEY WORDS

thyroid gland, differentiated carcinomas, medullary carcinoma, sorafenib, lenvatinib, vandetanib, cabozantinib, thyrosine-kinase inhibitors