Deshpande Hari A, Gettinger Scott, Sosa Julie Ann
Yale Cancer Center, Department of Medical Oncology.
Core Evid. 2010 Jun 15;4:43-8. doi: 10.2147/ce.s5996.
Thyroid cancer is a rare disease with an incidence of around 37,000 cases per year. However, its incidence is rising faster than many other cancers and for men this disease ranks highest overall in the rate of increase (2.4% annual increase) in cancer deaths. As the number of radioactive iodine-resistant thyroid cancers increases, the need for newer treatments has become more important. Axitinib is one of many new small molecule inhibitors of growth factor receptors that have shown promise in the treatment of many cancers. It targets the vascular endothelial growth factor receptors 1, 2 and 3.
The goal of this article is to review the published evidence for the use of axitinib in the treatment of thyroid cancer and define its therapeutic potential.
The major evidence of axitinib activity has appeared in meeting report abstracts. One phase II study has been published. This included patients with any histological type of thyroid cancer that was not amenable to treatment with radioactive iodine.
To date, in phase II clinical studies axitinib has demonstrated antitumor activity in advanced refractory thyroid cancer. As a monotherapy it resulted in a 30% response rate with another 38% of patients having stable disease. Axitinib appears to have a good tolerability profile, with hypertension being the most common grade 3 or greater side effect.
甲状腺癌是一种罕见疾病，每年发病率约为37000例。然而，其发病率的上升速度比许多其他癌症更快，在男性中，这种疾病在癌症死亡增长率（每年增长2.4%）方面总体排名最高。随着放射性碘难治性甲状腺癌数量的增加，对新型治疗方法的需求变得更加重要。阿昔替尼是众多新型生长因子受体小分子抑制剂之一，已在多种癌症治疗中显示出前景。它作用于血管内皮生长因子受体1、2和3。
本文的目的是回顾已发表的关于阿昔替尼治疗甲状腺癌的证据，并确定其治疗潜力。
阿昔替尼活性的主要证据出现在会议报告摘要中。已发表了一项II期研究。该研究纳入了任何组织学类型的、无法用放射性碘治疗的甲状腺癌患者。
迄今为止，在II期临床研究中，阿昔替尼已在晚期难治性甲状腺癌中显示出抗肿瘤活性。作为单一疗法，它导致30%的缓解率，另有38%的患者病情稳定。阿昔替尼似乎具有良好的耐受性，高血压是最常见的3级或更高级别的副作用。
