State of the art and future directions in the systemic treatment of medullary thyroid cancer

Purpose of review Systemic treatment is the only therapeutic option for patients with progressive, metastatic medullary thyroid cancer (MTC). Since the discovery of the rearranged during transfection (RET) proto-oncogene (100% hereditary, 60–90% sporadic MTC), research has focused on finding effective systemic therapies to target this mutation. This review surveys recent findings. Recent findings Multikinase inhibitors are systemic agents targeting angiogenesis, inhibiting growth of tumor cells and cells in the tumor environment and healthy endothelium. In the phase III EXAM and ZETA trials, cabozantinib and vandetanib showed progression-free survival benefit, without evidence of prolonged overall survival. Selpercatinib and pralsetinib are kinase inhibitors with high specificity for RET; phase I and II studies showed overall response rates of 73% and 71% in first line, and 69% and 60% in second line treatment, respectively. Although resistance mechanisms to mutation-driven therapy will be a challenge in the future, phase III studies are ongoing and neo-adjuvant therapy with selpercatinib is being studied. Summary The development of selective RET-inhibitors has expanded the therapeutic arsenal to control tumor growth in progressive MTC, with fewer adverse effects than multikinase inhibitors. Future studies should confirm their effectiveness, study neo-adjuvant strategies, and tackle resistance to these inhibitors, ultimately to improve patient outcomes...
Source: Current Opinion in Oncology - Category: Cancer & Oncology Tags: ENDOCRINE TUMORS: Edited by Christiane Jungels Source Type: research

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ConclusionsMost diagnoses were made below 30  years of age, and half of the subjects died from the malignant disease. Awareness of a possible malignancy is needed in patients with atypical symptoms. Regular screenings for cancer should also be considered, not only for gastrointestinal tumors.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Thyroid cancer represents 6% of all cancers diagnosed in patients less than 19 years of age [1] and the 2nd most common cancer diagnosed in adolescent and young adult females [2]. Mortality rates for thyroid cancer in pediatrics are low, but morbidity for patients can be significant [3]. Pediatric patients often present with metastatic disease, most commonly to cervical neck lymph nodes followed by the lungs [4, 5] requiring more extensive surgical dissection as well as RAI therapy [1]. Most patients face lifelong thyroid hormone replacement, and many pediatric patients will live with chronic residual disease.
Source: Cancer Genetics and Cytogenetics - Category: Genetics & Stem Cells Authors: Source Type: research
Nat Prod Res. 2022 Jan 18:1-9. doi: 10.1080/14786419.2021.2024532. Online ahead of print.ABSTRACTFive new triterpenoids, including four ursane types (1-4) and one oleanane type (5), together with 15 known ursane types pentacyclic triterpenoids (6-20) were isolated from the fruit spikes of Prunella vulgaris L., a traditional Chinese herbal medicine. Their structures were elucidated based on IR, HR-ESI-MS, and NMR spectroscopic data. The SW579 cell line was used to evaluate anti-thyroid cancer activities of (1-20). The results indicated that (7-9), (16), and (19) exhibited apparent inhibitory activity with IC50 values of 25....
Source: Cell Research - Category: Cytology Authors: Source Type: research
Expert Opin Pharmacother. 2022 Jan 18. doi: 10.1080/14656566.2022.2030704. Online ahead of print.ABSTRACTINTRODUCTION: The most common altered signaling found in aggressive iodine-refractory Thyroid cancer derived from follicular cells (RAI-TC) are RTK, MAPK, PI3K, WNT, BRAF, RAS, RET, and TP53. Tyrosine Kinase Inhibitors (TKI) are multi-kinase inhibitors able to act against different pathways, that elicit an anti-neoplastic activity.AREAS COVERED: The aim of this paper is to review recent novel molecular therapies of RAI-TC. Recently, sorafenib and lenvatinib, have been approved for the treatment of aggressive RAI-TC. Oth...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Authors: Source Type: research
Nat Prod Res. 2022 Jan 18:1-9. doi: 10.1080/14786419.2021.2024532. Online ahead of print.ABSTRACTFive new triterpenoids, including four ursane types (1-4) and one oleanane type (5), together with 15 known ursane types pentacyclic triterpenoids (6-20) were isolated from the fruit spikes of Prunella vulgaris L., a traditional Chinese herbal medicine. Their structures were elucidated based on IR, HR-ESI-MS, and NMR spectroscopic data. The SW579 cell line was used to evaluate anti-thyroid cancer activities of (1-20). The results indicated that (7-9), (16), and (19) exhibited apparent inhibitory activity with IC50 values of 25....
Source: Natural Product Research - Category: Biochemistry Authors: Source Type: research
Purpose The aim of the present study is to investigate the risk factors for hepatic dysfunction before radioiodine therapy in patients with differentiated thyroid cancer (DTC). Methods 996 patients (314 men, 682 women; age of 45.07±12.98 years) with postoperative DTC were recruited and divided into two groups including patients with and without hepatic dysfunction. The changes in baseline data and traced liver function levels, together with other metabolic profiles, were compared between the two groups. Result Overall, 31.6% of patients had hepatic dysfunction. Higher aspartate aminotransferase and/or alanine amin...
Source: BMJ Open - Category: General Medicine Authors: Tags: Open access, Diabetes and Endocrinology Source Type: research
We present a case of presurgical embolization of a C2 metastasis from a thyroid cancer using Onyx-18 injected by direct puncture (video 1). In this technical video, we stress the technical aspects of the direct puncture technique and the safety rules to avoid neurological complications. Video 1
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Technical video Source Type: research
J Oncol. 2022 Jan 6;2022:8809469. doi: 10.1155/2022/8809469. eCollection 2022.ABSTRACTRecent studies have demonstrated the utility and superiority of DNA repair-related genes as novel biomarkers for cancer diagnosis, prognosis, and therapy. Here, we aimed to screen the potential survival-related DNA repair-related genes in thyroid cancer (TC). TCGA datasets were utilized to analyze the differentially expressed DNA repair-related genes between TC and nontumor tissues. The K-M approach and univariate analysis were employed to screen survival-related genes. RT-PCR was employed to examine the expression of DNA repair-related g...
Source: Journal of Oncology - Category: Cancer & Oncology Authors: Source Type: research
Conclusions The optimal two-step age-based cutoff to predict DSS is 45 with 50 years for PTC, and 25 with 40 years for FTC, rather than 55 years currently used for DTC. Although, these two-step age-based cutoffs were marginally better from a statistical, from a clinical point of view the recently defined optimal single age cutoffs of 50 years for PTC, and 40 years for FTC might be preferable.PMID:35038308 | DOI:10.1530/EJE-21-1056
Source: European Journal of Endocrinology - Category: Endocrinology Authors: Source Type: research
Acta Oncol. 2022 Jan 16:1. doi: 10.1080/0284186X.2021.2023214. Online ahead of print.NO ABSTRACTPMID:35037554 | DOI:10.1080/0284186X.2021.2023214
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Source Type: research
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