Redifferentiation of Radioiodine Refractory Differentiated Thyroid Cancer for Reapplication of I-131 Therapy

Abstract

Although most differentiated thyroid cancers show excellent prognosis, treating radioiodine refractory differentiated thyroid cancer (RR-DTC) is challenging. Various therapies, including chemotherapy, radiotherapy, and targeted therapy, have been applied for RR-DTC but show limited effectiveness. Redifferentiation followed by radioiodine therapy is a promising alternative therapy for RR-DTC. Retinoic acids, histone deacetylase inhibitors, and peroxisome proliferator-activated receptor-gamma agonists are classically used as redifferentiation agents, and recent targeted molecules are also used for this purpose. Appropriate selection of redifferentiation agents for each patient, using current knowledge about genetic and biological characteristics of thyroid cancer, might increase the efficacy of redifferentiation treatment. In this review, we will discuss the mechanisms of these redifferentiation agents, results of recent clinical trials, and promising preclinical results.

Combined tazemetostat and MAPKi enhances differentiation of papillary thyroid cancer cells harbouring BRAFV600E by synergistically decreasing global trimethylation of H3K27

“…23 Increasing numbers of studies, including ours, have confirmed that tumour epigenetics-based therapeutics offer a new direction for differentiation therapy. 19,24,25 Kong et al found that histone hypermethylation resulted in cancer cell dedifferentiation and resistance to BRAF inhibitor treatment, which was largely mediated by H3K27me3.…”

Nevirapine inhibits migration and invasion in dedifferentiated thyroid cancer cells

“…The first is the high rate of metastasis to lymph nodes or other organs, which is as high as 30% to 59.1% . The second is the resistance to chemotherapy and conventional external beam radiotherapy . Metastatic thyroid cancer behaves aggressively and about two‐thirds of patients with metastatic disease ultimately present with radioiodine refractory disease .…”

“…1,[3][4][5] The second is the resistance to chemotherapy and conventional external beam radiotherapy. 6,7 Metastatic thyroid cancer behaves aggressively and about two-thirds of patients with metastatic disease ultimately present with radioiodine refractory disease. 8,9 Once it metastasizes to other organs it is hard to treat and therefore it is important to exploit new therapeutic agents which are effective in the treatment of metastatic thyroid cancer.…”

Untitled

“…Тому актуальними є питання ранньої діагностики, лікування та прогнозування появи РЙРМ. Існуючи літературні дані свідчать про розробку методів прогнозування поведінки пухлин на основі як загально-клінічних, так і гістологічних, іму нохімічних і молекулярно-генетичних чинників [7][8][9][10][11][12][13]. Відомим є NIS (натрій-йодсимпортер), імуногістохімічне визначення якого проводиться в гістологічному матеріалі папілярних карцином (ПК) ЩЗ, коли вже неможливо вплинути на хід оперативного втручання [14].…”