Management of Patients with Metastatic Medullary Thyroid Carcinoma: The Role for Systemic Therapy

2016 ◽  
pp. 157-164
Author(s):  
Gilbert G. Fareau
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Systemic Therapy ◽  
Medullary Thyroid

The dilemma of metastatic medullary thyroid carcinoma: when to start systemic treatment

2019 ◽  
Vol 105 (6) ◽  
pp. NP28-NP31
Author(s):  
Marco Siano ◽  
Salvatore Alfieri ◽  
Roberta Granata ◽  
Giuseppina Calareso ◽  
Ester Orlandi ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Medullary Thyroid Carcinoma ◽  
Systemic Therapy ◽  
Kinase Inhibitors ◽  
Locally Advanced ◽  
Tumor Burden ◽  
Bone Lesions ◽  
Progression Rate ◽  
Medullary Thyroid

Purpose: Two tyrosine kinase inhibitors (TKIs), vandetanib and cabozantinib, have been approved for recurrent/metastatic (R/M) medullary thyroid carcinoma (MTC). To date, it is still debated when and which TKI has to be started in R/M MTC patients. This is due to 1) TKI-related toxicity burden, 2) no overall survival benefit for either TKI, and 3) progression-free survival improvement in MTC subgroups ( RETM918T and RAS mutations) treated with cabozantinib. Herein, we present a case of R/M MTC with a discordant disease behavior because of spontaneous regression of some parenchymal sites along with progression of bone metastases, putting into the question the best timing for starting TKIs in R/M MTC. Methods: We report a 46-year-old man with relapse (lymph nodes in the neck and mediastinum) after curative treatment (total thyroidectomy plus central compartment and right neck dissection) for a locally advanced MTC with only somatic RETM918T mutation. Considering the low tumor burden, absence of symptoms, as well as the potential TKI-related side effects, we decided not to start systemic therapy when metastases first appeared. Results: Some lymph nodes spontaneously regressed, while new symptomatic bone lesions appeared with need for palliative radiotherapy. In total, first-line systemic therapy (cabozantinib) was started after 2 years since first distant metastases appearance. Conclusions: Radiologic progression of disease alone seems not to be adequate for MTC patients’ selection to be treated. The progression rate, the tumor burden, and the site of disease should also be taken into account for the clinical decision process.

Abstract #832: Metastatic Medullary Thyroid Carcinoma Presenting as Ectopic Cushing Syndrome

2017 ◽  
Vol 23 ◽  
pp. 179
Author(s):  
Sandeep Donagaon ◽  
Pramila Kalra ◽  
Anil Kumar ◽  
K. Harish ◽  
Shamim Sheik ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Cushing Syndrome ◽  
Medullary Thyroid

Abstract #1126: Clinical Validity of Rosettagx Reveal for the Accurate Diagnosis of Preoperative Medullary Thyroid Carcinoma Utilizing FNA Smears

2017 ◽  
Vol 23 ◽  
pp. 303
Author(s):  
Michal Kushnir ◽  
Nicole Massoll ◽  
Brianna Sewell ◽  
Alexis Smith ◽  
Lisa Goodman ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Accurate Diagnosis ◽  
Clinical Validity ◽  
Medullary Thyroid

Abstract #87: Long-Term Survival in a Patient with MEN2B and Metastatic Medullary Thyroid Carcinoma

2004 ◽  
Vol 10 ◽  
pp. 29-30
Author(s):  
Claudia Panzer ◽  
Robert Beazley ◽  
Stuart Chipkin ◽  
Susanne Ebner
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Term Survival ◽  
Long Term Survival ◽  
Medullary Thyroid

Localization of residual disease in medullary thyroid carcinoma by integrated 18F-DOPA PET / CT

2006 ◽  
Vol 114 (S 1) ◽  
Author(s):  
W Karges ◽  
H Dralle ◽  
B Boehm ◽  
AK Buck ◽  
SN Reske ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Residual Disease ◽  
Medullary Thyroid ◽  
Pet Ct
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