Chemotherapy with Doxorubicin in Progressive Medullary and Thyroid Carcinoma of the Follicular Epithelium

Abstract

Twenty-two patients (mean age 61) with metastasizing, progressive, nonradioiodine-accumulating thyroid carcinoma of the follicular epithelium were treated with doxorubicin between 2000 and 2005. Tumors were histologically classified as follicular in 15 patients (68%) and papillary in 7 patients (32%). In addition, nine patients (mean age 51 years) with medullary thyroid carcinoma were treated with doxorubicin between 1997 and 2005. Treatment consisted of doxorubicin: either 8 cycles of 15 mg/m2 weekly or 3 cycles of 60 mg/m2 every 3 weeks, repeated once, depending on response and side effects. The effect of therapy was evaluated by radiographic imaging, [18F] FDG-PET, and bone scans. In patients with papillary or follicular thyroid carcinoma, 5% had a partial regression over 6 months, 42% had stable disease for a median of 7 months (range: 1-22), and 53% had continuous progression established over 5 months (range: 1-11). Three patients died before completing chemotherapy. In patients with medullary thyroid carcinoma, 11% had a partial regression over 6 months followed by stable disease for 3 months, 11% had stable disease over 7 months, and 79% demonstrated progressive disease established over 5 months (range: 2-12). Doxorubicin can be a valid chemotherapy option, especially for advanced or metastatic thyroid carcinoma of the follicular epithelium.

Phase II Efficacy and Pharmacogenomic Study of Selumetinib (AZD6244; ARRY-142886) in Iodine-131 Refractory Papillary Thyroid Carcinoma with or without Follicular Elements

“…Historical data involving chemotherapy are difficult to interpret due to small sample sizes, retrospective reporting, inconsistent response assessment criteria, and lack of controls. A conservative estimate of the lower range of response rate of the best-studied agent in this disease, doxorubicin, is 5% using at least one published study (26). Therefore, we determined that selumetinib would be worthy of further evaluation if the response rate (CR + PR) were at least 20%.…”

Neoadjuvant target therapy of differentiated thyroid cancer (clinical observation)

“…При этом частота объективных эффектов была относительно невысо-кой -всего 15 % [11], а токсичность значимой с учетом случаев смерти, связанных с лечением [12]. Заключение С внедрением в клиническую практику таргетных препаратов удалось значительно улучшить результаты лечения.…”

Novel Therapies Against Aggressive Differentiated Thyroid Carcinomas

“…Historically, adriamycin alone or in combination has been the most-common cytotoxic drug used. A retrospective study from 2008 with adriamycin alone showed only a modest efficacy with one patient achieving a partial response out of 22 patients [15]. Another retrospective study from 2013 with adriamycin plus cisplatin or cyclophosphamide showed a response rate of 20% [16].…”