Krajewska Jolanta, Gawlik Tomasz, Jarzab Barbara
a Nuclear Medicine and Endocrine Oncology Department , Maria Skłodowska-Curie Memorial Institute and Cancer Center , Gliwice Branch, Gliwice , Poland.
Expert Opin Pharmacother. 2017 Aug;18(11):1049-1060. doi: 10.1080/14656566.2017.1340939. Epub 2017 Jul 3.
Multi kinase inhibitors (MKIs) are new drugs, which show activity against receptors of different growth factors leading to the inhibition of tumor cells growth and proliferation. This review summarizes a 10-year experience with the use of MKIs in thyroid cancer (TC). It focuses not only on sorafenib, lenvatinib, vandetanib and cabozantinib, already approved in TC, but also presents an overview of the results of different trials with distinct MKIs so far carried out in TC. Areas covered: Published results of phase I, II and III studies and other reports evaluated the efficacy of different targeted drugs in TC. Expert opinion: Despite numerous clinical trials with distinct MKIs, only four of them unequivocally demonstrated a beneficial effect on progression free survival in radioiodine refractory differentiated or medullary TC. In contrast to other solid tumors, we are still lacking in convincing evidences of their impact on overall survival. We still do not have any strong proof fulfilling evidence-based medicine criteria, when to start MKIs and which drug to use. The questions whether we really have to wait for disease progression in patients with a large tumor burden and/or aggressive types TC or when to stop MKIs treatment remain open.
多激酶抑制剂（MKIs）是一类新药，可作用于不同生长因子的受体，从而抑制肿瘤细胞的生长和增殖。本综述总结了10年来在甲状腺癌（TC）中使用MKIs的经验。它不仅聚焦于已被批准用于TC的索拉非尼、乐伐替尼、凡德他尼和卡博替尼，还概述了迄今为止在TC中开展的不同MKIs的各类试验结果。涵盖领域：I期、II期和III期研究的已发表结果以及其他评估不同靶向药物在TC中疗效的报告。专家观点：尽管进行了众多不同MKIs的临床试验，但其中只有四项明确显示对放射性碘难治性分化型或髓样TC的无进展生存期有有益影响。与其他实体瘤不同，我们仍缺乏它们对总生存期影响的确凿证据。我们仍没有任何符合循证医学标准的确凿证据，即何时开始使用MKIs以及使用哪种药物。对于肿瘤负荷大的患者和/或侵袭性类型的TC患者，我们是否真的必须等待疾病进展，以及何时停止MKIs治疗，这些问题仍然没有答案。
