Bikas Athanasios, Vachhani Shivangi, Jensen Kirk, Vasko Vasyl, Burman Kenneth D
a Division of Endocrinology, Department of Medicine , MedStar Washington Hospital Center , Washington , DC , USA.
b Department of Pediatrics , Uniformed Services University of the Health Sciences , Bethesda , MD , USA.
Expert Rev Clin Pharmacol. 2016 Oct;9(10):1299-1313. doi: 10.1080/17512433.2016.1204230. Epub 2016 Jul 15.
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.
患有进展性、转移性、放射性碘难治性分化型甲状腺癌（DTC）的患者，以及晚期髓样癌（MTC）和间变性甲状腺癌患者，其治疗选择有限。甲状腺癌相关分子机制的最新发现为疾病的发病机制和进展提供了深入了解。在这方面，靶向治疗已成为治疗这些患者的一种有前景的替代方法。涵盖领域：酪氨酸激酶抑制剂（TKIs）已在甲状腺癌中得到广泛研究：索拉非尼和乐伐替尼已被美国食品药品监督管理局（FDA）批准用于治疗转移性、放射性碘难治性DTC，而凡德他尼和卡博替尼已被FDA批准用于晚期MTC。此外，几种其他的多靶点或特异性TKIs目前正在甲状腺癌中进行研究。本手稿对甲状腺癌靶向治疗的文献进行了广泛综述，包括其使用的基本原理、临床试验以及关于其使用的专家意见。对PubMed上出现的英文文献进行了全面审查，特别是过去5年的手稿。专家评论：晚期、进展性、转移性甲状腺癌患者应评估是否可参加临床试验，或应接受FDA和欧洲药品管理局（EMA）批准的药物之一进行治疗。
