Agosto Salgado Sarimar
Assistant Member, Endocrine Oncologist, Head & Neck-Endocrine Oncology Department, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612 USA.
Ther Adv Endocrinol Metab. 2021 Oct 29;12:20420188211054692. doi: 10.1177/20420188211054692. eCollection 2021.
Anaplastic thyroid cancer is a rare aggressive malignancy resulting in poor outcomes, including significant morbidity and mortality. Historically, the overall survival of patients with anaplastic thyroid cancer has been less than 12 months. Multidisciplinary approaches combining surgery, radiation, and chemotherapy have been implemented to control this ominous disease. The evolution in science and technology has promoted deeper knowledge in the genetic pathways and mechanisms driving advance thyroid cancer. Furthermore, understanding molecular pathways resulted in the application of antineoplastic agents used in other tumors to thyroid cancer and the development of new highly selective drugs. A major landmark in anaplastic thyroid cancer management history was recently reached with the approval of BRAF and MEK inhibitor combination, specifically dabrafenib and trametinib for BRAF-mutated anaplastic thyroid cancer; this treatment has improved survival and outcomes in this population. Similarly, newer kinase inhibitors and immunotherapy are further shifting advanced thyroid cancer management to consider as first-line therapy inhibiting actionable oncogenic alterations. Therefore, newer treatment paradigms are incorporating molecular testing to provide personalized cancer care in anaplastic thyroid cancer. In this review, the principal aim is to provide an overview of the available international data on tyrosine kinase inhibitors and immunotherapy in the management of anaplastic thyroid cancer.
间变性甲状腺癌是一种罕见的侵袭性恶性肿瘤，预后较差，包括显著的发病率和死亡率。从历史上看，间变性甲状腺癌患者的总生存期不到12个月。已采用手术、放疗和化疗相结合的多学科方法来控制这种凶险的疾病。科学技术的发展促进了对驱动晚期甲状腺癌的遗传途径和机制的更深入了解。此外，对分子途径的了解导致了其他肿瘤中使用的抗肿瘤药物应用于甲状腺癌，并开发了新的高选择性药物。最近，BRAF和MEK抑制剂联合使用，特别是达拉非尼和曲美替尼用于BRAF突变的间变性甲状腺癌的批准，在间变性甲状腺癌治疗史上具有重大里程碑意义；这种治疗改善了该人群的生存率和预后。同样，更新的激酶抑制剂和免疫疗法正在进一步改变晚期甲状腺癌的治疗方式，将抑制可操作的致癌改变作为一线治疗方案。因此，更新的治疗模式正在纳入分子检测，以在间变性甲状腺癌中提供个性化的癌症护理。在本综述中，主要目的是概述酪氨酸激酶抑制剂和免疫疗法在间变性甲状腺癌治疗中的现有国际数据。
