Consensus on the management of advanced medullary thyroid carcinoma on behalf of the Working Group of Thyroid Cancer of the Spanish Society of Endocrinology (SEEN) and the Spanish Task Force Group for Orphan and Infrequent Tumors (GETHI).
BACKGROUND
In Spain medullary thyroid carcinoma (MTC) would not exceed 80 new cases per year and less than half of them would be good candidates for systemic treatment with novel agents.


METHODS
Relevant literature was reviewed, including PubMed searches supplemented with additional articles.


RESULTS
The consensus summarizes the clinical outcomes in terms of activity and toxicity of each of the available drugs. A brief summary of the minimum requirements in terms of follow up and genetic counseling around MTC is also included.


CONCLUSIONS
Only those patients with objective imaging progression in the last 12-14 months with large volume of disease are clear candidates to start systemic treatment. However, those patients with low disease volume should be considered for 'wait and see' strategy until symptoms of the disease appear. Multidisciplinary approach for the management of MTC patient is mandatory nowadays.
Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain. Electronic address: jcgalofre@unav.es.
Juan C
JC
Galofré
Service of Endocrinology and Nutrition, Hospital Universitario de Cruces, Vizcaya, Spain.
Javier
J
Santamaría Sandi
Service of Medical Oncology, Hospital Universitario de la Vall d'Hebron, Barcelona, Spain.
Jaume
J
Capdevila
Service of Endocrinology and Nutrition, Hospital Universitario Virgen del Rocio, Sevilla, Spain.
Elena
E
Navarro González
Service of Endocrinology and Nutrition, Hospital Universitario de la Vall d'Hebron, Barcelona, Spain.
Carles
C
Zafón Llopis
Service of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Teresa
T
Ramón Y Cajal Asensio
CIBERDEM Service of Endocrinology and Nutrition, Hospital Universitario de Bellvitge, Spain.
José Manuel
JM
Gómez Sáez
Service of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain.
Paula
P
Jiménez-Fonseca
Service of Endocrinology and Nutrition, Hospital Universitario de Móstoles, Madrid, Spain.
Garcilaso
G
Riesco Eizaguirre
Service of Medical Oncology, Hospital Ramón y Cajal, Madrid, Spain.
Enrique
E
Grande
D000813:Anilides / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor; D002116:Calcitonin / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000032:analysis; D018276:Carcinoma, Medullary / Q000453:epidemiology / Q000235:genetics / Q000628:therapy*; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging / Q000379:methods; D019468:Disease Management; D004317:Doxorubicin / Q000627:therapeutic use; D056726:Genetic Association Studies; D006801:Humans; D009362:Neoplasm Metastasis; D011379:Prognosis; D051096:Proto-Oncogene Proteins c-ret / Q000235:genetics; D011725:Pyridines / Q000627:therapeutic use; D011878:Radiotherapy / Q000379:methods; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000628:therapy*
D000813:Anilides; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D011725:Pyridines; C558660:cabozantinib; D004317:Doxorubicin; D002116:Calcitonin; D051096:Proto-Oncogene Proteins c-ret; C099282:RET protein, human
Antígeno carcinoembrionario; Cabozantinib; Calcitonin; Calcitonina; Carcinoembryonic antigen; Carcinoma medular de tiroides; Consenso de expertos; Cáncer de tiroides; Expert consensus; Guidelines; Guía; Medullary thyroid carcinoma; Thyroid cancer; Vandetanib