Review article
https://doi.org/10.20471/acc.2020.59.s1.09
Kinase Inhibitors in the Treatment of Thyroid Cancer: Institutional Experience
Matea Pešorda
; Clinical Department of Nuclear Medicine and Radiation Protection, Zagreb University Hospital Centre, Zagreb, Croatia
Sanja Kusačić Kuna
; Clinical Department of Nuclear Medicine and Radiation Protection, Zagreb University Hospital Centre, Zagreb, Croatia; The University of Zagreb School of Medicine, Zagreb, Croatia
Dražen Huić
; Clinical Department of Nuclear Medicine and Radiation Protection, Zagreb University Hospital Centre, Zagreb, Croatia; The University of Zagreb School of Medicine, Zagreb, Croatia
Davorin Herceg
; Clinical Department of Oncology, Zagreb University Hospital Centre, Zagreb, Croatia; The University of Zagreb School of Dental Medicine, Zagreb, Croatia
Marija Despot
; Clinical Department of Nuclear Medicine and Radiation Protection, Zagreb University Hospital Centre, Zagreb, Croatia
Tatjana Samardžić
; Clinical Department of Nuclear Medicine and Radiation Protection, Zagreb University Hospital Centre, Zagreb, Croatia
Milena Gnjidić
; Clinical Department of Oncology, Zagreb University Hospital Centre, Zagreb, Croatia
Borislav Belev
; Clinical Department of Oncology, Zagreb University Hospital Centre, Zagreb, Croatia; The University of Zagreb School of Medicine, Zagreb, Croatia
Abstract
Although most patients with thyroid cancer have a favorable clinical course, some
patients develop a more aggressive type of cancer and exhibit more rapid disease progression with
worse prognosis. Those patients usually exhibit mutations of proteins such as tyrosine kinase enzymes
that play a significant role in regulation of tumor proliferation and spreading. Development of targeted
therapies is based on the inhibition of mutated kinases which are involved in the MAPK signaling
pathway. The aim of this study was to present the initial results of clinical experience with kinase
inhibitors in patients with metastatic differentiated thyroid cancer (DT C), poorly differentiated thyroid
cancer (PDT C), and medullary thyroid cancer (MTC) who exhibited rapid disease progression.
A total of 17 adult patients (11 women, mean age 53.3 years) managed for progressive, metastatic
disease were included in the study. Twelve patients with DT C and PDT C were previously tested for
BRAF mutations, of whom nine that had tumor tissue negative for the BRAF V600E mutation received
sorafenib, while three patients with tumors harboring the BRAF V600E mutation were treated
with vemurafenib. Patients with MTC were treated with sunitinib, vandetanib, and sorafenib. Two
patients with tumors harboring the BRAF mutation treated with vemurafenib showed restoration of
radioiodine uptake. Most of patients showed significant improvement in disease status but of limited
duration until disease progression. Although there was an improvement in progression-free survival,
future research has to achieve a greater and longer-lasting response, probably by utilizing combined
targeted therapy.
Keywords
thyroid cancer; tyrosine kinase inhibitors
Hrčak ID:
247904
URI
Publication date:
1.11.2020.
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