Chen Kan, Gao Yun, Shi Fei, Cao Guangqiang, Bao Jiandong
Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, China.
Onco Targets Ther. 2018 Jan 19;11:459-463. doi: 10.2147/OTT.S142598. eCollection 2018.
Medullary thyroid carcinoma (MTC) is a rare malignancy originating from calcitonin-producing parafollicular C cells of the thyroid. Neither radiotherapy nor chemotherapy has demonstrated durable objective responses in patients with advanced MTC. Vandetanib and cabozantinib are the 2 tyrosine kinase inhibitors recently approved by the US Food and Drug Administration, which are not affordable for most Chinese patients. Herein, we report a case of an MTC patient who responded to apatinib, a Chinese homemade tyrosine kinase inhibitor-targeted vascular endothelial growth factor receptor. The patient was treated with thyroid lobectomy but developed MTC with extensive metastasis. The levels of serum calcitonin and carcino-embryonic antigen were much higher than the normal range. Apatinib was given at a dose of 500 mg daily and adjusted according to tolerance. Sixteen weeks following apatinib administration, the patient achieved a partial response, which lasted more than 9 weeks. No severe toxicity or drug-related side effect was observed during the treatment. Therefore, apatinib could be a new option for the treatment of advanced MTC.
甲状腺髓样癌（MTC）是一种罕见的恶性肿瘤，起源于甲状腺分泌降钙素的滤泡旁C细胞。对于晚期MTC患者，放疗和化疗均未显示出持久的客观缓解效果。凡德他尼和卡博替尼是美国食品药品监督管理局最近批准的2种酪氨酸激酶抑制剂，但大多数中国患者难以承受其费用。在此，我们报告1例MTC患者对阿帕替尼（一种中国国产的靶向血管内皮生长因子受体的酪氨酸激酶抑制剂）有反应。该患者接受了甲状腺叶切除术，但发生了伴有广泛转移的MTC。血清降钙素和癌胚抗原水平远高于正常范围。阿帕替尼的给药剂量为每日500 mg，并根据耐受性进行调整。阿帕替尼给药16周后，患者获得部分缓解，持续超过9周。治疗期间未观察到严重毒性或药物相关副作用。因此，阿帕替尼可能是晚期MTC治疗的一种新选择。
