[Poorly differentiated thyroid carcinomas: new therapeutic considerations].
For most differentiated thyroid carcinomas, as papillary and follicular carcinomas, following total thyroidectomy and 131I therapy for thyroid remnant ablation, treatment with thyroid hormones to suppress TSH levels will reduce the growth of any remaining thyroid cancer cells, and thyroid cell-specific radiation therapy will either cure or control the disease. Thyroid carcinomas are considered poorly differentiated when they start to lose such functions as iodine uptake and thyrotropin-dependence for growth and production of thyroid proteins like NIS, thyroglobulin and desiodases. One of the greatest challenges in the management of patients with follicular cell-derived thyroid cancer is the treatment of tumors that progressed despite surgery, (131)I and T4 suppression of TSH. With the better knowledge of the abnormal molecular signaling in thyroid cancer cells, actually known targeted cancer therapies, directed against molecules involved in neoplastic transformation, are being used. As the critical molecular requirements for tumor initiation, maintenance and progression are identified, combination therapies with targeted agents acting on each of them will improve the treatment of poorly differentiated thyroid carcinoma.
Graf
Hans
H
Serviço de Endocrinologia e Metabologia, Universidade Federal do Paraná, Curitiba, PR. hansgraf@bsi.com.br
D018263:Adenocarcinoma, Follicular / Q000628:therapy*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002291:Carcinoma, Papillary / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D011518:Proto-Oncogene Proteins / Q000187:drug effects*; D013964:Thyroid Neoplasms / Q000628:therapy*
D000970:Antineoplastic Agents; D007457:Iodine Radioisotopes; D011518:Proto-Oncogene Proteins