Figueiredo Ana Sofia, Andrea-Ferreira Patricia
Faculty of Medicine, University of Porto, Porto, Portugal.
Department of General Surgery, Centro Hospitalar Sao Joao, Faculty of Medicine, University of Porto, Porto, Portugal.
Endocr Metab Immune Disord Drug Targets. 2018;18(6):555-564. doi: 10.2174/1871530318666180611095622.
Anaplastic thyroid carcinoma is rare, but represents the deadliest type of thyroid cancer that is characterised by a rapid course. Diagnosis is usually made at a late stage, when more than half of the patients have distant metastasis. Our main purpose is to review the current information on anaplastic thyroid aetiology and risk factors that might contribute to an earlier diagnosis as well as to give new perspectives regarding the most recent treatment options and future directions.
The treatment options are mainly palliative and lack efficacy. In particular, the multikinase inhibitors, BRAF inhibitors and other directed agents aim to stabilize the tumour growth and might enable a radical surgery with curative intent.
With the mutational landscape investigation and the discovery of new targets, new directed treatments are being tried. Considering the current tendency to be more conservative regarding the multinodular goiter approach and some differentiated thyroid carcinomas treatment, it is vital to understand that it might evolve to anaplastic cancers.
间变性甲状腺癌较为罕见,但却是最致命的甲状腺癌类型,其病程进展迅速。诊断通常在晚期进行,此时超过半数患者已发生远处转移。我们的主要目的是回顾有关间变性甲状腺病因及可能有助于早期诊断的危险因素的现有信息,并就最新的治疗选择和未来方向提供新的观点。
治疗选择主要是姑息性的,且缺乏疗效。特别是多激酶抑制剂、BRAF抑制剂和其他靶向药物旨在稳定肿瘤生长,并可能使根治性手术具有治愈意图。
随着突变图谱研究和新靶点的发现,正在尝试新的靶向治疗方法。鉴于目前对多结节性甲状腺肿和一些分化型甲状腺癌的治疗倾向于更加保守,必须认识到它们可能会演变成间变性癌症。