title: New treatment modalities in advanced thyroid cancer.
abstract: BACKGROUND
  Thyroid cancer is a heterogeneous disease that is classified into differentiated thyroid carcinoma (DTC), undifferentiated/anaplastic thyroid carcinoma (ATC) and medullary thyroid carcinoma. Results of conventional treatment modalities in advanced thyroid cancer have been disappointing and therefore, new therapies are needed.
  
  
  METHODS
  We searched PubMed, The Cochrane Library, Medline and EMBASE databases and abstracts published in annual proceedings for new treatment modalities in advanced thyroid cancer. We also searched for ongoing trials in www.clinicaltrials.gov.
  
  
  RESULTS
  Six phase I, 17 phase II and 1 phase III trials with tyrosine kinase inhibitors were carried out. We found 2 pilot studies and 11 phase II trials with redifferentiation therapies, mainly in DTC. For antiproliferative approaches, three phase I and four phase II trials were found. Immunomodulatory gene therapy was tested in a pilot study in ATC patients. Two phase II trials were carried out with immunotherapy. One phase I and nine phase II trials were found with radionucleotide therapy in patients with DTC.
  
  
  CONCLUSIONS
  The developments in the treatment of advanced thyroid cancer are intriguing. Future trials should aim at combinations of targeted agents with or without other treatment modalities, and will hopefully contribute to further improvement of outcomes.
authors.affiliation: Departments of Clinical Oncology. Electronic address: h.w.kapiteijn@lumc.nl.
authors.forename: E
authors.initials: E
authors.lastname: Kapiteijn
authors.affiliation: Departments of Clinical Oncology.
authors.forename: T C
authors.initials: TC
authors.lastname: Schneider
authors.affiliation: Departments of Pathology.
authors.forename: H
authors.initials: H
authors.lastname: Morreau
authors.affiliation: Departments of Clinical Oncology.
authors.forename: H
authors.initials: H
authors.lastname: Gelderblom
authors.affiliation: Departments of Clinical Oncology.
authors.forename: J W R
authors.initials: JWR
authors.lastname: Nortier
authors.affiliation: Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: J W A
authors.initials: JWA
authors.lastname: Smit
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015316:Genetic Therapy / Q000379:methods; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D013964:Thyroid Neoplasms / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents