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Harvesting the Low-Hanging Fruit: Kinase Inhibitors for Therapy of Advanced Medullary and Nonmedullary Thyroid Cancer

2010; Oxford University Press; Volume: 95; Issue: 6 Linguagem: Inglês

10.1210/jc.2010-0800

1945-7197

James A. Fagin, R. Michael Tuttle, David G. Pfister,

Cancer-related Molecular Pathways

A pproximately 37,000 new cases of thyroid cancer are diagnosed annually in the United States, and of these, about 10–20% present with or ultimately develop distant metastases (1). The prognosis of patients with distant metastases from non-medullary thyroid cancer (non-MTC) remains favorable when these are responsive to radioactive iodine (RAI). By contrast, the 10-yr survival after discovery of distant metastases is only 10% if these have lost the ability to trap or retain iodine. Patients with metastatic RAI-refractory lesions that are also positive on fluoro-deoxyglucose-positron emission tomography (FDG-PET) have a particularly poor prognosis. In addition to patients with distant metastatic disease, those with unresectable local recurrences also have a higher mortality. Palliative external beam irradiation plays an important role in local disease control; however, conventional chemotherapeutic agents are relatively ineffective in thyroid cancer (2). Recent clinical trials with several kinase inhibitors have shown promising evidence of activity in thyroid cancer of follicular origin (3,4,5,6) as well as in MTC (7,8).