Novel therapies against aggressive differentiated thyroid carcinomas

Abstract

The incidence of thyroid cancer (TC) is increasing. Although the majority of these cancers have a good prognosis, 10% of these will develop local recurrence and/or distant metastases. Conventional cytotoxic chemotherapy has been largely replaced by molecular-target therapies, but it can still have a role. Two tyrosine kinase inhibitors have been approved for the treatment of advanced differentiated TC. They significantly improve progression-free survival, but at the cost of frequent and potentially serious adverse effects. At the moment, there are multiple clinical trials with other tyrosine kinase inhibitors and other drugs. We present a review of the current standard of care and what is up to come in the treatment of advanced TC.

Anaplastic Thyroid Cancer: Clinical Picture of the Last Two Decades at a Single Oncology Referral Centre and Novel Therapeutic Options

“…Different TKIs that target the abovementioned pathways have been developed and studied in ATC patients.. The mechanisms of action underlying the therapeutic effects of these drugs have been previously reviewed by our group [29] (see Table 3).…”

Recent advances in understanding immune phenotypes of thyroid carcinomas: prognostication and emerging therapies

“…NCT02501096 is a phase IB/II trial with the aim of defining the maximum tolerated dose for lenvatinib - a potent inhibitor of vascular endothelial growth factor (VEGF) receptors, fibroblast growth factor receptors, platelet-derived growth factor receptor alpha, c-KIT, and rearranged during transfection (RET) - in combination with pembrolizumab in patients with several types of solid tumors, including advanced TCs 57 . A trial started in April 2017 (NCT02973997) is investigating pembrolizumab plus lenvatinib in patients with locally recurrent and unresectable or distant metastatic TCs (or both) to evaluate the safety and efficacy of this combination 58 . An ongoing trial (NCT03181100) has the primary objective of determining the effects of several targeted therapies plus atezolizumab on overall survival (OS) of patients with ATC; its secondary objectives are to evaluate the safety and efficacy of targeted therapy plus atezolizumab in ATCs and PDTCs, to determine the OS in patients with PDTCs treated with targeted therapy plus atezolizumab, and to determine the OS of patients with ATC and PDTC treated with taxanes plus atezolizumab 59 .…”