Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Endocrinology and Medical Oncology, Mayo Clinic, Rochester, Minnesota.
Endocr Rev. 2019 Dec 1;40(6):1573-1604. doi: 10.1210/er.2019-00007.
The treatment of advanced thyroid cancer has undergone rapid evolution in the last decade, with multiple kinase inhibitor drug approvals for each subtype of thyroid cancer and a number of other commercially available drugs that have been studied for this indication. Although most of the US Food and Drug Administration (FDA)-approved drugs are antiangiogenic multikinase inhibitors-vandetanib, cabozantinib, sorafenib, lenvatinib-there are two FDA indications that are mutation specific-dabrafenib/trametinib for BRAF-mutated anaplastic thyroid cancer and larotrectinib for NTRK-fusion thyroid cancer. Furthermore, other mutation-specific drugs, immunotherapies, and novel strategies for advanced thyroid cancer are under investigation. Understanding the molecular basis of thyroid cancer, the drugs of interest for treatment of advanced thyroid cancer, and how these drugs can be administered safely and in the appropriate clinical scenario are the topics of this review.
在过去的十年中，晚期甲状腺癌的治疗方法迅速发展，每种甲状腺癌亚型都有多种激酶抑制剂药物获得批准，还有许多其他已针对该适应症进行研究的商业上可获得的药物。尽管大多数美国食品和药物管理局 (FDA) 批准的药物都是抗血管生成多激酶抑制剂-凡德他尼、卡博替尼、索拉非尼、仑伐替尼-但有两个 FDA 适应症是针对突变的-达拉非尼/曲美替尼用于 BRAF 突变的间变性甲状腺癌，larotrectinib 用于 NTRK 融合甲状腺癌。此外，还有其他针对特定突变的药物、免疫疗法以及用于晚期甲状腺癌的新策略正在研究中。了解甲状腺癌的分子基础、治疗晚期甲状腺癌的相关药物以及如何安全地在适当的临床情况下使用这些药物是本综述的主题。
