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Targeted Therapy for Medullary Thyroid Cancer: A Review
Medullary thyroid cancers (MTCs) constitute between 2 and 5% of all thyroid cancers. The 10-year overall survival (OS) rate of patients with localized disease is around 95% while that of patients with regional stage disease is about 75%. Only 20% of patients with distant metastases at diagnosis surv...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635342/ https://www.ncbi.nlm.nih.gov/pubmed/29057215 http://dx.doi.org/10.3389/fonc.2017.00238 |
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author | Priya, S. R. Dravid, Chandra Shekhar Digumarti, Raghunadharao Dandekar, Mitali |
author_facet | Priya, S. R. Dravid, Chandra Shekhar Digumarti, Raghunadharao Dandekar, Mitali |
author_sort | Priya, S. R. |
collection | PubMed |
description | Medullary thyroid cancers (MTCs) constitute between 2 and 5% of all thyroid cancers. The 10-year overall survival (OS) rate of patients with localized disease is around 95% while that of patients with regional stage disease is about 75%. Only 20% of patients with distant metastases at diagnosis survive 10 years which is significantly lower than for differentiated thyroid cancers. Cases with regional metastases at presentation have high recurrence rates. Adjuvant external radiation confers local control but not improved OS. The management of residual, recurrent, or metastatic disease till a few years ago was re-surgery with local measures such as radiation. Chemotherapy was used with marginal benefit. The development of targeted therapy has brought in a major advantage in management of such patients. Two drugs—vandetanib and cabozantinib—have been approved for use in progressive or metastatic MTC. In addition, several drugs acting on other steps of the molecular pathway are being investigated with promising results. Targeted radionuclide therapy also provides an effective treatment option with good quality of life. This review covers the rationale of targeted therapy for MTC, present treatment options, drugs and methods under investigation, as well as an outline of the adverse effects and their management. |
format | Online Article Text |
id | pubmed-5635342 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-56353422017-10-20 Targeted Therapy for Medullary Thyroid Cancer: A Review Priya, S. R. Dravid, Chandra Shekhar Digumarti, Raghunadharao Dandekar, Mitali Front Oncol Oncology Medullary thyroid cancers (MTCs) constitute between 2 and 5% of all thyroid cancers. The 10-year overall survival (OS) rate of patients with localized disease is around 95% while that of patients with regional stage disease is about 75%. Only 20% of patients with distant metastases at diagnosis survive 10 years which is significantly lower than for differentiated thyroid cancers. Cases with regional metastases at presentation have high recurrence rates. Adjuvant external radiation confers local control but not improved OS. The management of residual, recurrent, or metastatic disease till a few years ago was re-surgery with local measures such as radiation. Chemotherapy was used with marginal benefit. The development of targeted therapy has brought in a major advantage in management of such patients. Two drugs—vandetanib and cabozantinib—have been approved for use in progressive or metastatic MTC. In addition, several drugs acting on other steps of the molecular pathway are being investigated with promising results. Targeted radionuclide therapy also provides an effective treatment option with good quality of life. This review covers the rationale of targeted therapy for MTC, present treatment options, drugs and methods under investigation, as well as an outline of the adverse effects and their management. Frontiers Media S.A. 2017-10-06 /pmc/articles/PMC5635342/ /pubmed/29057215 http://dx.doi.org/10.3389/fonc.2017.00238 Text en Copyright © 2017 Priya, Dravid, Digumarti and Dandekar. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Priya, S. R. Dravid, Chandra Shekhar Digumarti, Raghunadharao Dandekar, Mitali Targeted Therapy for Medullary Thyroid Cancer: A Review |
title | Targeted Therapy for Medullary Thyroid Cancer: A Review |
title_full | Targeted Therapy for Medullary Thyroid Cancer: A Review |
title_fullStr | Targeted Therapy for Medullary Thyroid Cancer: A Review |
title_full_unstemmed | Targeted Therapy for Medullary Thyroid Cancer: A Review |
title_short | Targeted Therapy for Medullary Thyroid Cancer: A Review |
title_sort | targeted therapy for medullary thyroid cancer: a review |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635342/ https://www.ncbi.nlm.nih.gov/pubmed/29057215 http://dx.doi.org/10.3389/fonc.2017.00238 |
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