Medical Oncology Department, Hospital Clinic Barcelona.
Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS.
Curr Opin Oncol. 2021 May 1;33(3):184-195. doi: 10.1097/CCO.0000000000000727.
We review the new systemic treatment strategies for differentiated thyroid carcinoma, as well as the acquaintance of its molecular biology.
Multiple kinase inhibitor drugs have become the standard therapy for thyroid cancer, albeit several adverse effects. In the last few years, new molecules have raised with an overall safety profile. Most of them, are considered targeted therapies directed toward driven-molecules alterations, such as neurotrophic tyrosine kinase receptor (NTRK) inhibitors for NTRK-fusion thyroid cancer and rearranged during transfection (RET) inhibitors for RET-fusion thyroid cancer. Recently, promising outcomes and safety data have been presented. Furthermore, other novel strategies for advanced thyroid carcinoma are currently investigated in clinical trials.The ability to provide precision medicine to patients in routine clinical settings depends on the availability of molecular profiling test at their cancer centers. The impossibility to perform molecular characterization could turn out to be a diagnostic and treatment limitation for some patients.
The treatment of advanced differentiated thyroid carcinoma has undergone rapid evolution in the last decade. An emerging treatment era is coming. From now to then, we will need to face the different types of diagnostic tools for molecular characterization, their interpretation and, finally the access to targeted therapies.
我们综述分化型甲状腺癌的新系统治疗策略以及对其分子生物学的认识。
多种激酶抑制剂药物已成为甲状腺癌的标准治疗方法,尽管存在一些不良反应。在过去的几年中,出现了新的分子,具有总体安全性。其中大多数被认为是针对驱动分子改变的靶向治疗药物,例如针对 NTRK 融合甲状腺癌的神经营养酪氨酸激酶受体 (NTRK) 抑制剂和针对 RET 融合甲状腺癌的 RET 抑制剂。最近,已提出了有希望的结果和安全性数据。此外,目前正在临床试验中研究其他用于晚期甲状腺癌的新策略。在常规临床环境中为患者提供精准医学的能力取决于其癌症中心是否能够进行分子谱检测。对于某些患者来说,无法进行分子特征分析可能会成为诊断和治疗的限制。
在过去的十年中,晚期分化型甲状腺癌的治疗发生了快速演变。一个新兴的治疗时代即将到来。从现在到那时,我们将需要面对不同类型的分子特征诊断工具、它们的解释以及最终获得靶向治疗的机会。