Departments of Clinical Oncology.
Departments of Clinical Oncology.
Ann Oncol. 2012 Jan;23(1):10-18. doi: 10.1093/annonc/mdr117. Epub 2011 Apr 6.
Thyroid cancer is a heterogeneous disease that is classified into differentiated thyroid carcinoma (DTC), undifferentiated/anaplastic thyroid carcinoma (ATC) and medullary thyroid carcinoma. Results of conventional treatment modalities in advanced thyroid cancer have been disappointing and therefore, new therapies are needed.
We searched PubMed, The Cochrane Library, Medline and EMBASE databases and abstracts published in annual proceedings for new treatment modalities in advanced thyroid cancer. We also searched for ongoing trials in www.clinicaltrials.gov.
Six phase I, 17 phase II and 1 phase III trials with tyrosine kinase inhibitors were carried out. We found 2 pilot studies and 11 phase II trials with redifferentiation therapies, mainly in DTC. For antiproliferative approaches, three phase I and four phase II trials were found. Immunomodulatory gene therapy was tested in a pilot study in ATC patients. Two phase II trials were carried out with immunotherapy. One phase I and nine phase II trials were found with radionucleotide therapy in patients with DTC.
The developments in the treatment of advanced thyroid cancer are intriguing. Future trials should aim at combinations of targeted agents with or without other treatment modalities, and will hopefully contribute to further improvement of outcomes.
甲状腺癌是一种异质性疾病，分为分化型甲状腺癌（DTC）、未分化/间变性甲状腺癌（ATC）和髓样甲状腺癌。晚期甲状腺癌的常规治疗方法的效果令人失望，因此需要新的治疗方法。
我们检索了 PubMed、The Cochrane Library、Medline 和 EMBASE 数据库以及年度会议的摘要，以寻找晚期甲状腺癌的新治疗方法。我们还在 www.clinicaltrials.gov 上搜索了正在进行的试验。
共进行了 6 项 I 期、17 项 II 期和 1 项 III 期酪氨酸激酶抑制剂试验。我们发现了 2 项先导研究和 11 项分化治疗的 II 期试验，主要是在 DTC 中。对于抗增殖方法，发现了 3 项 I 期和 4 项 II 期试验。在 ATC 患者中进行了免疫调节基因治疗的试点研究。进行了 2 项免疫治疗的 II 期试验。在 DTC 患者中，进行了 1 项 I 期和 9 项 II 期放射性核素治疗试验。
晚期甲状腺癌治疗的发展令人关注。未来的试验应旨在靶向药物与其他治疗方法的联合应用，并有望有助于进一步改善治疗效果。
