title: Update on thyroid cancer treatment.
abstract: Surgery and radioiodine therapy are usually effective for most patients with differentiated thyroid cancer. However, poorly differentiated and anaplastic thyroid carcinomas represent a challenge to physicians on the basis of the current cancer treatment modalities. These cancer subtypes are often lethal and refractory to radioiodine therapy as well as most of the common chemotherapy drugs. Several kinase inhibitors are promising targeted therapies for these malignancies; however, clinical trials involving these drugs have provided controversial results and their clinical use is still under debate. Advanced medullary thyroid carcinomas may also be refractory to conventional therapies and novel kinase inhibitors may also be useful to control tumor progression in certain patients. Novel evidence is emerging that thyroid cancer is a stem cell disease, thereby implying that the driving force of thyroid cancers is a subset of undifferentiated cells (thyroid cancer stem cells) with unlimited growth potential and resistance to conventional therapeutic regimens. Thyroid cancer stem cells have been proposed as responsible for tumor invasiveness, metastasis, relapse and differentiation. Therefore, drugs that selectively target these cells could serve as a cornerstone in the treatment of poorly differentiated thyroid cancer.
authors.affiliation: Endocrinology, Department of Clinical & Molecular Biomedicine of the University of Catania, Garibaldi-Nesima Hospital, Catania, Italy. regalbut@unict.it
authors.forename: Concetto
authors.initials: C
authors.lastname: Regalbuto
authors.forename: Francesco
authors.initials: F
authors.lastname: Frasca
authors.forename: Gabriella
authors.initials: G
authors.lastname: Pellegriti
authors.forename: Pasqualino
authors.initials: P
authors.lastname: Malandrino
authors.forename: Ilenia
authors.initials: I
authors.lastname: Marturano
authors.forename: Isidoro
authors.initials: I
authors.lastname: Di Carlo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pezzino
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D018278:Carcinoma, Neuroendocrine; D002986:Clinical Trials as Topic; D020249:Hormone Replacement Therapy; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D058990:Molecular Targeted Therapy; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D065646:Thyroid Carcinoma, Anaplastic; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy
chemical_list: D000970:Antineoplastic Agents; D007457:Iodine Radioisotopes; D047428:Protein Kinase Inhibitors