Current Understanding of Nonsurgical Interventions for Refractory Differentiated Thyroid Cancer: a Systematic Review

Jones, Heidi; Green, Victoria; England, James; Greenman, John

doi:10.2144/fsoa-2021-0041

Cited by 3 publications

(5 citation statements)

References 80 publications

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“…RAIR-DTC is relatively uncommon, as shown in a previous study in which it only occurred in 2.2% of the 5,163 DTC patients treated ( 4 ). Nonetheless, RAIR-DTC was associated with a low 10-year OS rate (10%) ( 15 ); therefore, there is a critical need for effective treatment. Sorafenib was the first tyrosine kinase inhibitor approved by the FDA for RAIR-DTC.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Apatinib in Radioiodine-Refractory Differentiated Thyroid Carcinoma

Shi

Fang

et al. 2022

Front. Endocrinol.

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ObjectivesOur aim was to describe our experience in using apatinib as treatment for radioiodine-refractory differentiated thyroid carcinoma (RAIR-DTC).MethodsForty-seven patients undergoing apatinib treatment for RAIR-DTC were prospectively enrolled in this study. The study endpoints were objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and rate of adverse events.ResultsNo patients achieved complete response, while 36 (76.6%) and 8 (17.0%) patients achieved partial response and stable disease, respectively. The ORR and DCR were 76.6% and 93.6%, respectively. The median PFS and OS were 18 and 59 months, respectively. A total of 91 adverse events occurred, of which 21 were graded as grade 3 or higher. There were no drug-related deaths.ConclusionsApatinib has distinct anti-RAIR-DTC efficacy in terms of ORR, PFS, and OS and has a favorable safety profile. It is a feasible treatment option for RAIR-DTC.

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Section: Discussionmentioning

confidence: 99%

Feasibility of Apatinib in Radioiodine-Refractory Differentiated Thyroid Carcinoma

Shi

Fang

et al. 2022

Front. Endocrinol.

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“…Thus, treatment options for patients with metastatic lesions refractory to radioiodine therapy are limited, and the reported 10-year survival rate is 70%. [1][2][3] Recently, several genetic mutations associated with the development of differentiated thyroid carcinoma have been identified, such as translocations, BRAF (V600E) and RAS gene point mutations in papillary thyroid carcinoma and RAAS gene point mutations and PPAR-y and PAX8 rearrangements identified in follicular thyroid carcinoma. Most of the mutations found result in overexpression of tyrosine kinase receptors.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, tyrosine kinase inhibitors (TKI) have been developed as a treatment option for recurrent disease. 2 Randomized clinical trials (RCTs) are the most appropriate primary study design to assess the benefits and harms of health interventions. However, RCTs may contain systematic errors that lead to methodological biases capable of overestimating or underestimating the results, lowering the reliability of the study.…”

Section: Introductionmentioning

confidence: 99%

“…Most of the mutations found result in overexpression of tyrosine kinase receptors. Therefore, tyrosine kinase inhibitors (TKI) have been developed as a treatment option for recurrent disease 2 …”

Section: Introductionmentioning

confidence: 99%

“…They generally present a good prognosis; however, some cases may show an aggressive evolution. Thus, treatment options for patients with metastatic lesions refractory to radioiodine therapy are limited, and the reported 10‐year survival rate is 70% 1–3 …”

Section: Introductionmentioning

confidence: 99%

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The methodological and reporting quality of randomized controlled trials of tyrosine kinase inhibitors for advanced differentiated thyroid cancer: Meta‐research study

Dedivitis,

Castro,

Boni

et al. 2024

Head & Neck

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IntroductionClinical trials on tyrosine kinase inhibitors (TKI) treatment have shown an improvement in overall and progression‐free survival in patients with advanced differentiated thyroid cancer. However, it is necessary to evaluate these studies to assess methodological biases and inconsistencies that may impact the effects.ObjectiveTo map and assess the methodological quality of randomized clinical trials (RCTs) regarding randomization, allocation concealment, blinding, and selective reporting bias.MethodsRCTs assessing the efficacy and safety of TKI for the treatment of advanced differentiated thyroid cancer were included. The search was performed in the MEDLINE database. The included RCTs were assessed for the adequacy of the methodological steps, as recommended by the Cochrane Risk of Bias tool.ResultsNine studies were analyzed, of which 77.7% were classified as low risk of bias regarding selective reporting and 33.3% as high risk of reporting bias. The mean time between protocol registration and study publication was approximately 5.11 years. Moreover, 66.7% were classified as low risk of bias for randomization and allocation concealment, and 33.3% did not specify the randomization process and allocation concealment in a way that would allow the identification of occurrences of bias. Concerning blinding of participants and outcome assessors, 77.8% of the RCTs reported adequate blinding and were classified as having a low risk of bias, 11.1% had a high risk of bias, and 11.1% had insufficient information and were classified as having unclear risk of bias. Regarding the blinding of the outcome assessors, 33.3% did the blinding correctly, 11.1% did not blind, and 55.6% did not provide enough information.ConclusionOverall, the assessed RCTs were predominantly at low risk of bias. The critical evaluation of these studies is essential to have confidence in the treatment estimated effect that will support clinical decision‐making and provide information to preclude future clinical study flaws.

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Covalent CES2 Inhibitors Protect against Reduced Formation of Intestinal Organoids by the Anticancer Drug Irinotecan

Shi

Yan

Eades

et al. 2022

CDM

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Background: Irinotecan is widely used to treat various types of solid and metastatic cancer. It is an ester prodrug and its hydrolytic metabolite (SN-38) exerts potent anticancer activity. Irinotecan is hydrolyzed primarily by carboxylesterase-2 (CES2), a hydrolase abundantly present in the intestine such as the duodenum. We have identified several potent and covalent CES2 inhibi¬tors such as remdesivir and sofosbuvir. Remdesivir is the first small molecule drug approved for COVID-19, whereas sofosbuvir is a paradigm-shift medicine for hepatitis C viral infection. Irinotecan is generally well-tolerated but associated with severe/life-threatening diarrhea due to intestinal accu¬¬mula¬tion of SN-38. Objective: This study was to test the hypothesis that remdesivir and sofosbuvir protect against irinotecan-induced epithelial injury associated with gastrointestinal toxicity. Methods: To test this hypothesis, formation of organoids derived from mouse duodenal crypts, a robust cellular model for intestinal regeneration, was induced in the presence or absence of irinotecan +/- pretreatment with a CES2 drug inhibitor. Results: Irinotecan profoundly inhibited the formation of intestinal organoids and the magnitude of the inhibition was greater with female crypts than their male counterparts. Consistently, crypts from female mice had significantly higher hydrolytic activity toward irinotecan. Critically, remdesivir and sofosbuvir both reduced irinotecan hydrolysis and reversed irinotecan-reduced formation of organoids. Human duodenal samples robustly hydrolyzed irinotecan, stable CES2 transfection induced cytotoxicity and the cytotoxicity was reduced by CES2 drug inhibitor. Conclusion: These findings establish a therapeutic rationale to reduce irinotecan-gastrointestinal injury and serve as a cellular foundation to develop oral formulations of irinotecan with high safety.

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Current Understanding of Nonsurgical Interventions for Refractory Differentiated Thyroid Cancer: a Systematic Review

Cited by 3 publications

References 80 publications

Feasibility of Apatinib in Radioiodine-Refractory Differentiated Thyroid Carcinoma

Feasibility of Apatinib in Radioiodine-Refractory Differentiated Thyroid Carcinoma

The methodological and reporting quality of randomized controlled trials of tyrosine kinase inhibitors for advanced differentiated thyroid cancer: Meta‐research study

Covalent CES2 Inhibitors Protect against Reduced Formation of Intestinal Organoids by the Anticancer Drug Irinotecan

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