Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, 8000 Aarhus C, Denmark.
Clinic for Plastic, Aesthetic and Hand Surgery, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany.
Int J Mol Sci. 2019 Dec 18;21(1):10. doi: 10.3390/ijms21010010.
Thyroid cancer is the most common endocrine malignancy. Most thyroid cancer types respond well to conventional treatment consisting of surgery and radioactive iodine (RAI) therapy. Unfortunately, some thyroid cancer types are resistant to surgical and RAI therapy. Multikinase inhibitors (MKIs) can be used in the treatment of advanced refractory thyroid cancers. The objective of this review is to give an update on MKI treatment (lenvatinib, sorafenib, sunitinib, cabozantinib, pazopanib, vandetanib) of thyroid cancer, regarding its efficacy and safety profile. We evaluated 212 articles through a PubMed search. A total of 20 articles met the inclusion and none the exclusion criteria. The studies showed promising progression-free survival rates compared to placebo treatment from earlier studies and similar or better results compared to the SELECT and DECISION trials. Adverse effects (AEs) are substantial in the treatment with MKIs. Almost all patients treated with these novel drugs experienced AEs. It is therefore crucial to focus on the management of AEs for a decent long-term outcome. The AEs are often more severe in patients with high efficacy of MKIs, which could indicate a correlation. Taken together, the novel therapeutic regimen with MKIs has shown favorable results in otherwise treatment-resistant thyroid cancer.
甲状腺癌是最常见的内分泌恶性肿瘤。大多数甲状腺癌类型对包括手术和放射性碘（RAI）治疗在内的常规治疗反应良好。不幸的是，一些甲状腺癌类型对手术和 RAI 治疗具有抗药性。多激酶抑制剂（MKIs）可用于治疗晚期难治性甲状腺癌。本综述的目的是更新 MKI（仑伐替尼、索拉非尼、舒尼替尼、卡博替尼、帕唑帕尼、凡德他尼）治疗甲状腺癌的疗效和安全性概况。我们通过 PubMed 搜索评估了 212 篇文章。共有 20 篇文章符合纳入标准，没有一篇文章符合排除标准。与早期研究相比，这些研究显示出有希望的无进展生存率，与 SELECT 和 DECISION 试验相比，结果相似或更好。MKIs 治疗的不良反应（AEs）相当多。几乎所有接受这些新药治疗的患者都经历了不良反应。因此，关注 AEs 的管理对于获得良好的长期结果至关重要。在具有高 MKI 疗效的患者中，AEs 往往更严重，这可能表明存在相关性。总的来说，新型 MKI 治疗方案在其他治疗耐药的甲状腺癌中显示出良好的效果。
