de Andrade Fernanda Accioly, Bulzico Daniel, Corbo Rossana, Vaisman Fernanda
Endocrine Oncology Unit, Brazilian National Cancer Institute, INCA, Rio de Janeiro, Brazil.
Nuclear Medicine Section, Brazilian National Cancer Institute, INCA, Rio de Janeiro, Brazil.
Endocrine. 2025 Mar;87(3):943-950. doi: 10.1007/s12020-024-04114-6. Epub 2024 Nov 29.
Medullary thyroid carcinoma (MTC) is a rare cancer that originates from germline RET proto-oncogene mutations in all hereditary forms and from somatic RET mutations in most sporadic cases. Currently, highly selective RET inhibitors have been approved for clinical use in patients with RET mutations with persistent, recurrent or metastatic disease. This therapy has proven efficacy, low toxicity, and a limited impact on patients' quality of life. However, for recurrent or metastatic RET-negative disease, few systemic therapies are available. Multikinase inhibitors are used; however, tumour cells frequently develop resistance mechanisms, or treatment must be discontinued due to the high incidence of side effects. In this context, peptide receptor radionuclide therapy (PRRT) may be a treatment option, but its clinical utility remains under investigation. The aim of this review is to evaluate the evidence of PRRT in MTC and discuss its limitations in the RET inhibitor era.
甲状腺髓样癌（MTC）是一种罕见的癌症，所有遗传性形式均起源于种系RET原癌基因突变，而大多数散发性病例起源于体细胞RET突变。目前，高度选择性RET抑制剂已被批准用于治疗患有持续性、复发性或转移性疾病的RET突变患者。这种疗法已被证明有效、毒性低，且对患者生活质量影响有限。然而，对于复发性或转移性RET阴性疾病，可用的全身治疗方法很少。多激酶抑制剂被使用；然而，肿瘤细胞经常产生耐药机制，或者由于副作用发生率高而必须停止治疗。在这种情况下，肽受体放射性核素治疗（PRRT）可能是一种治疗选择，但其临床实用性仍在研究中。本综述的目的是评估PRRT在MTC中的证据，并讨论其在RET抑制剂时代的局限性。
