Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain.
Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Expert Rev Anticancer Ther. 2022 Nov;22(11):1239-1247. doi: 10.1080/14737140.2022.2139680. Epub 2022 Nov 9.
Anaplastic thyroid cancer (ATC) is one of the most lethal diseases known to humans with a median survival of 5 months. The American Thyroid Association (ATA) recently published guidelines for the treatment of this dreadful thyroid malignancy.
This review presents the current therapeutic landscape of this challenging disease. We also present the results from trials published over the last five years and summarize currently active clinical trials.
Recent attempts to improve the prognosis of these tumors are moving toward personalized medicine, basing the treatment decision on the specific genetic profile of the individual tumor. The positive results of dabrafenib and trametinib for ATC harboring the BRAF V600E mutation have provided a useful treatment option. For the other genetic profiles, different drugs are available and can be used to individualize the treatment, likely using drug combinations. Combinations of drugs act on different molecular pathways and achieve inhibition at separate areas. With new targeted therapies, average survival has improved considerably and death from local disease progression or airway compromise is less likely with improvement in quality of life. Unfortunately, the results remain poor in terms of survival.
间变性甲状腺癌（ATC）是人类已知的最致命疾病之一，中位生存期为 5 个月。美国甲状腺协会（ATA）最近发布了治疗这种可怕的甲状腺恶性肿瘤的指南。
本综述介绍了这种具有挑战性疾病的当前治疗现状。我们还介绍了过去五年发表的试验结果，并总结了目前正在进行的临床试验。
最近，人们试图通过个性化医疗来改善这些肿瘤的预后，根据个体肿瘤的特定基因谱来做出治疗决策。针对携带 BRAF V600E 突变的 ATC，达布拉非尼和曲美替尼的积极结果提供了一种有用的治疗选择。对于其他基因谱，有不同的药物可供使用，并可用于个体化治疗，可能使用药物联合治疗。联合药物作用于不同的分子途径，并在不同的区域实现抑制。随着新的靶向治疗方法的出现，平均生存时间有了显著提高，生活质量得到改善，局部疾病进展或气道阻塞导致的死亡风险降低。不幸的是，在生存方面，结果仍然很差。
