Target-based therapies in thyroid cancer
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 5
Abstract
Poor prognosis of thyroid cancer and advanced disease together with the absence of effective therapeutic measures has induced recent intensified basic and clinical research in this area. Complete total thyroidectomy is the treatment of choice for PTC, FTC, and MTC. Radioiodine is routinely recommended in high-risk patients and considered in intermediate risk DTC patients. Patients with unresectable or metastatic thyroid cancer are candidates for systemic treatment with targeted therapeutics. Several genetic alterations in different molecular pathways in TC have been shown in the past few decades, associated with TC development and progression. Rearranged during transfection (RET)/ PTC gene rearrangements, RET mutations, BRAF mutations, RAS mutations, and vascular endothelial growth factor receptor 2 angiogenesis pathways are some of the known pathways determinants in the development of TC. Tyrosine kinase inhibitors (TKIs) are emerging as new therapies of aggressive TC, including DTC, MTC, and anaplastic thyroid cancer, is capable of inducing clinical responses and stabilization of disease. These drugs prolong median progression-free survival, but until now no significant increase has been observed on overall survival; side effects are common. New efforts are made to find new more effective and safe compounds and to personalize the therapy in each TC patient. Targeted novel compounds have been demonstrated to induce clinical responses and stabilization of disease.
Authors and Affiliations
Arup Kumar Misra, Pramod Kumar Sharma, Rajesh Kumar, Ajay Gupta, Govind Mishra
Keywords
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