title: [Refractory thyroid cancers].
abstract: Refractory thyroid cancers include medullary and differentiated cancers with locally advanced disease that is not amenable to surgery or with distant metastases, differentiated thyroid carcinomas being refractory to radio-iodine treatment and all anaplastic carcinomas. These carcinomas are rare, with an estimated incidence in France of 350 new cases per year. Their management may benefit from the TUTHYREF network. Kinase inhibitors inhibit kinases of the VEGF receptors, and this inhibits angiogenesis, and some of these agents also inhibit other kinases of the MAPkinase pathway. These inhibitors are effective in differentiated and medullary thyroid cancers, and induce a partial response or a long-term stabilisation in more than half of patients. Their toxicity is significant and these treatments should be given only to selected patients with locally advanced or metastatic disease, with progression or with clinical symptoms.
authors.affiliation: Institut Gustave-Roussy, université Paris-Sud, service de médecine nucléaire et d'oncologie endocrinienne, 94805 Villejuif cedex, France. schlumbg@igr.fr
authors.forename: Martin
authors.initials: M
authors.lastname: Schlumberger
authors.forename: Cécile
authors.initials: C
authors.lastname: Chougnet
authors.forename: Eric
authors.initials: E
authors.lastname: Baudin
authors.forename: Sophie
authors.initials: S
authors.lastname: Leboulleux
mesh_terms: D018263:Adenocarcinoma, Follicular; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D018278:Carcinoma, Neuroendocrine; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm / Q000235:genetics / Q000502:physiology; D006801:Humans; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors; D013964:Thyroid Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D017211:Treatment Failure
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D040262:Receptors, Vascular Endothelial Growth Factor