Targeted molecular therapies in thyroid carcinoma.
Thyroid cancer incidence has significantly increased in the last three decades and many patients seek medical attention for its treatment every year. Among follicular cell-derived tumors, the majority are differentiated thyroid carcinomas (DTC), whose prognosis is very good with only 15% of the cases presenting disease persistence or recurrence after initial treatment. Medullary thyroid carcinoma has a worse prognosis, especially in patients with diffused cancers at the time of initial surgery. Traditional treatment options for persistent or recurrent disease include additional surgery, radioiodine treatment and TSH-suppression in DTC patients; external beam radiotherapy, and cytotoxic chemotherapy, often have low efficacy and many patients with advanced disease ultimately die. In the last two decades many of the molecular events involved in cancer formation have been uncovered. This knowledge has prompted the development of novel therapeutic strategies mainly based on the inhibition of key molecular mediators of the tumorigenic process. In particular the class of small-molecule tyrosine kinase inhibitors was enriched by many compounds that have reached clinical trials and in some cases have had approval for clinical use in specific cancers. Many of these compounds entered clinical trials also for locally advanced or metastatic thyroid carcinomas showing very promising results.
Romagnoli
Serena
S
Department of Internal Medicine, University of Perugia, Perugia, Italy.
Moretti
Sonia
S
Voce
Pasquale
P
Puxeddu
Efisio
E
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000077784:Axitinib; D001557:Benzenesulfonates / Q000627:therapeutic use; D018276:Carcinoma, Medullary / Q000188:drug therapy* / Q000235:genetics; D002291:Carcinoma, Papillary / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D007191:Indazoles / Q000627:therapeutic use; D007211:Indoles / Q000627:therapeutic use; D009536:Niacinamide / Q000031:analogs & derivatives / Q000627:therapeutic use; D009841:Oligonucleotides; D010671:Phenylurea Compounds; D010880:Piperidines / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000145:classification / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use; D000077157:Sorafenib; D000077210:Sunitinib; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000235:genetics
D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D007093:Imidazoles; D007191:Indazoles; D007211:Indoles; D009841:Oligonucleotides; D010671:Phenylurea Compounds; D010880:Piperidines; D047428:Protein Kinase Inhibitors; D011725:Pyridines; D011758:Pyrroles; D011799:Quinazolines; D009536:Niacinamide; D000077157:Sorafenib; D000077784:Axitinib; C519562:imetelstat; D000077210:Sunitinib; C452423:vandetanib