Novel concepts for initiating multitargeted kinase inhibitors in radioactive iodine refractory differentiated thyroid cancer

Differentiated thyroid cancer is a common malignancy with an excellent prognosis. Patients typically present with a thyroid nodule identified on physical exam or imaging. Fine needle aspiration (FNA) is the diagnostic modality of choice; ultrasound of the neck is used preoperatively to evaluate lymphadenopathy. Surgery is the mainstay of treatment, with partial or total thyroidectomy (with or without lymphadenectomy). Intra-operatively, identification of the recurrent laryngeal nerve and preservation of the parathyroid glands is imperative. Postoperatively, patients are considered for adjuvant radioactive iodine ablation. Risk stratification systems are available to assist patient selection for therapy. Surveillance is completed with serial physical exams, laboratory studies, ultrasound, and radioactive iodine scanning. Recurrence can be managed with surgery, thyroid-stimulating hormone suppression, radioactive iodine ablation, radiation, or kinase inhibitors. This review contains 8 figures, 6 tables, and 50 references. Key Words: Bethesda classification, differentiated thyroid cancer, follicular thyroid cancer, papillary thyroid cancer, radioactive iodine, thyroid nodule, thyroidectomy

Download Full-text

Differentiated Thyroid Cancer

10.2310/7800.16001 ◽

2019 ◽

Author(s):

Rebecca Tuttle ◽

William Cance ◽

James Howe

Keyword(s):

Thyroid Cancer ◽

Thyroid Nodule ◽

Differentiated Thyroid Cancer ◽

Radioactive Iodine ◽

Kinase Inhibitors ◽

Needle Aspiration ◽

Thyroid Stimulating Hormone ◽

Diagnostic Modality ◽

Radioactive Iodine Ablation ◽

Common Malignancy

Differentiated thyroid cancer is a common malignancy with an excellent prognosis. Patients typically present with a thyroid nodule identified on physical exam or imaging. Fine needle aspiration (FNA) is the diagnostic modality of choice; ultrasound of the neck is used preoperatively to evaluate lymphadenopathy. Surgery is the mainstay of treatment, with partial or total thyroidectomy (with or without lymphadenectomy). Intra-operatively, identification of the recurrent laryngeal nerve and preservation of the parathyroid glands is imperative. Postoperatively, patients are considered for adjuvant radioactive iodine ablation. Risk stratification systems are available to assist patient selection for therapy. Surveillance is completed with serial physical exams, laboratory studies, ultrasound, and radioactive iodine scanning. Recurrence can be managed with surgery, thyroid-stimulating hormone suppression, radioactive iodine ablation, radiation, or kinase inhibitors. This review contains 8 figures, 6 tables, and 50 references. Key Words: Bethesda classification, differentiated thyroid cancer, follicular thyroid cancer, papillary thyroid cancer, radioactive iodine, thyroid nodule, thyroidectomy

Download Full-text

New-generation mutitargeted tyrosine kinase inhibitors in the treatment of radioactive iodine-refractory differentiated thyroid cancer

Head and neck tumors (HNT) ◽

10.17650/2222-1468-2015-5-2-30-34 ◽

2015 ◽

Vol 5 (2) ◽

pp. 30

Author(s):

A. M. Mudunov

Keyword(s):

Thyroid Cancer ◽

Tyrosine Kinase ◽

Tyrosine Kinase Inhibitors ◽

Differentiated Thyroid Cancer ◽

Radioactive Iodine ◽

Kinase Inhibitors ◽

New Generation

Download Full-text

On the role of autophagy in the progression of differentiated thyroid cancer (literature review)

Siberian Journal of Oncology ◽

10.21294/1814-4861-2021-20-6-134-140 ◽

2022 ◽

Vol 20 (6) ◽

pp. 134-140

Author(s):

K. A. Garipov ◽

Z. A. Afanaseva ◽

Z. I. Abramova

Keyword(s):

Thyroid Cancer ◽

Targeted Therapy ◽

Tyrosine Kinase ◽

Tyrosine Kinase Inhibitors ◽

Differentiated Thyroid Cancer ◽

Radioactive Iodine ◽

Kinase Inhibitors ◽

Radioactive Iodine Therapy ◽

Effect Of Treatment

The aim of the study was to analyze and summarize available literature data on the role of autophagy in thyroid cancer. Material and methods. We analyzed 34 publications available from pubmed and elibrary. Ru databases concerning thyroid cancer and autophagy. Results. The review discussed the role of autophagy in the progression of thyroid cancer. The development of autophagy-targeted therapy was shown can improve treatment for thyroid cancer. Differentiated thyroid cancer (dtc) is the most common endocrine malignancy. Treatment of dtc patients who are resistant to radioactive iodine therapy is a major challenge. Molecular targeted therapy using tyrosine kinase inhibitors significantly improves treatment outcomes. Conclusion. To enhance the therapeutic effect of treatment with multi-target tyrosine kinase inhibitors, as well as to overcome drug resistance, it is necessary to study the role of autophagy in the development and progression of thyroid cancer.

Download Full-text

EFFICACY AND SAFETY OF MULTI-TARGETED KINASE INHIBITORS IN PROGRESSIVE, RADIOIODINE-REFRACTORY DIFFERENTIATED THYROID CANCERS: A META-ANALYSIS

Journal of Cancer & Allied Specialties ◽

10.37029/jcas.v2i1.50 ◽

2016 ◽

Vol 2 (1) ◽

Author(s):

Mutahir A Tunio ◽

Mushabbab AlAsiri ◽

Yasser Bayoumi

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Radioactive Iodine ◽

Kinase Inhibitors ◽

Meta Analysis ◽

Locally Advanced ◽

Progression Free Survival ◽

Cochrane Library ◽

Differentiated Thyroid Cancers ◽

The Impact

Purpose: A meta-analysis was conducted to evaluate the impact of oral multitargeted kinase inhibitors (MTKIs) in radioactive-iodine refractory locally advanced, recurrent/metastatic differentiated thyroid cancer (DTC) on disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) rates. Materials and Methods: The PubMed/MEDLINE, CANCERLIT, EMBASE, Cochrane Library database and other search engines were searched to identify randomised controlled trials (RCTs) comparing MTKIs with placebo in locally advanced, recurrent/metastatic DTC. Pooled data were expressed as odds ratio (OR), with 95% con dence intervals (CIs, Mantel–Haenszel xed-effect model). Results: Three RCTs with a total patient population of 954 patients were identi ed. The use of MTKIs was associated with improved PFS (OR: 0.262, 95% CI: 0.19–0.35; heterogeneity (I2) = 22.4%; P < 0.0001), improved DCR (complete and partial responses + stable disease, P < 0.0001) and improved OS 0.66, 95% CI: 0.46–0.96 (I2 = 43%, P = 0.034). Lenvatinib (compliance = 87%) was associated with more grade ≥3 hypertension. However, its other adverse effects were much lower than sorafenib (compliance = 56%) and vandetanib. Conclusion: In radioactive iodine-refractory recurrent, metastatic DTC patients, lenvatinib and sorafenib were associated with improved PFS, DRC and OS rates, while the compliance was better with lenvatinib. Key words: Meta-analysis, multitargeted kinase inhibitors, progressive differentiated thyroid cancer, radioactive iodine- refractory

Download Full-text

Cabozantinib, Nivolumab, and Ipilimumab in Treating Patients With Radioactive Iodine-Refractory Differentiated Thyroid Cancer That Progressed After VEGFR-Targeted Therapy

Case Medical Research ◽

10.31525/ct1-nct03914300 ◽

2019 ◽

Author(s):

Keyword(s):

Thyroid Cancer ◽

Targeted Therapy ◽

Differentiated Thyroid Cancer ◽

Radioactive Iodine

Download Full-text

Neoadjuvant Therapy in Differentiated Thyroid Cancer

International Journal of Surgical Oncology ◽

10.1155/2016/3743420 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Rajan P. Dang ◽

Daniel McFarland ◽

Valerie H. Le ◽

Nadia Camille ◽

Brett A. Miles ◽

...

Keyword(s):

Thyroid Cancer ◽

Neoadjuvant Chemotherapy ◽

Neoadjuvant Therapy ◽

Differentiated Thyroid Cancer ◽

Potential Role ◽

Kinase Inhibitors ◽

Tracheal Resection ◽

Complete Surgical Resection ◽

Select Trial ◽

Short Time

Objectives. Invasion of differentiated thyroid cancer (DTC) into surrounding structures can lead to morbid procedures such as laryngectomy and tracheal resection. In these patients, there is a potential role for neoadjuvant therapy.Methods. We identified three studies involving the treatment of DTC with neoadjuvant chemotherapy: two from Slovenia and one from Japan.Results. These studies demonstrate that in selected situations, neoadjuvant chemotherapy can have a good response and allow for a more complete surgical resection, the treatment of DTC. Additionally, the SELECT trial shows that the targeted therapy lenvatinib is effective in the treatment of DTC and could be useful as neoadjuvant therapy for this disease due to its short time to response. Pazopanib has also demonstrated promise in phase II data.Conclusions. Thus, chemotherapy in the neoadjuvant setting could possibly be useful for managing advanced DTC. Additionally, some of the new tyrosine kinase inhibitors (TKIs) hold promise for use in the neoadjuvant setting in DTC.

Download Full-text