title: Targeted therapies in thyroid cancer: an extensive review of the literature.
abstract: Patients with progressive, metastatic, RAI-refractory differentiated thyroid cancer (DTC), as well as patients with advanced medullary (MTC) and anaplastic thyroid cancer represent a cohort for which therapeutic options are limited. The recent discoveries in the molecular mechanisms implicated in TC have provided insight of the pathogenesis and progression of disease. In that respect, targeted therapies have emerged as a promising alternative for the treatment of those patients. Areas covered: Tyrosine Kinase Inhibitors (TKIs) have been studied extensively in TC: sorafenib and lenvatinib have been approved by the FDA for the treatment of metastatic, RAI-refractory DTC, while vandetanib and cabozantinib are FDA approved for use in advanced MTC. Moreover, several additional TKIs, multi-targeted or specific, are currently under investigation in TC. The current manuscript provides an extensive review of the literature regarding targeted therapies in TC including the rationale behind their use, the clinical trials and an expert opinion on their use. Literature in English appearing at PubMed was thoroughly reviewed, especially manuscripts of the last 5 years. Expert commentary: Patients with advanced, progressive, metastatic TC should be evaluated for enrollment in a clinical trial or should be placed on treatment with one of the FDA- and EMA- approved agents.
authors.affiliation: a Division of Endocrinology, Department of Medicine , MedStar Washington Hospital Center , Washington , DC , USA.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Bikas
authors.affiliation: a Division of Endocrinology, Department of Medicine , MedStar Washington Hospital Center , Washington , DC , USA.
authors.forename: Shivangi
authors.initials: S
authors.lastname: Vachhani
authors.affiliation: b Department of Pediatrics , Uniformed Services University of the Health Sciences , Bethesda , MD , USA.
authors.forename: Kirk
authors.initials: K
authors.lastname: Jensen
authors.affiliation: b Department of Pediatrics , Uniformed Services University of the Health Sciences , Bethesda , MD , USA.
authors.forename: Vasyl
authors.initials: V
authors.lastname: Vasko
authors.affiliation: a Division of Endocrinology, Department of Medicine , MedStar Washington Hospital Center , Washington , DC , USA.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Burman
keywords: TKI; anaplastic thyroid cancer; cabozantinib; differentiated thyroid cancer; lenvatinib; medullary thyroid cancer; sorafenib; thyroid cancer; tyrosine kinase inhibitors; vandetanib