Second Primary Malignancies in Cancer Survivors

Use of multikinase inhibitors/lenvatinib in patients with synchronous/metachronous cancers coinciding with radioactive‐resistant differentiated thyroid cancer

“…[7][8][9][10]12,13,[16][17][18][19][20][21][22][23] A number of factors, including (i) endogenous such as inherited/genetic predisposition (whether or not as part of specific syndromes) (Table 1 [24][25][26][27] ), abnormal embryo development, immune-associated diseases and/or comorbidities affecting carcinogen sensitivity; (ii) behavioral or lifestyle influences and environmental exposures; (iii) surveillance bias, or late iatrogenic effects of therapies for DTC/other primary tumors, could explain the enhanced general SPC risk and, particularly, in DTC patients. 3,4,15,18 Specifically, the association of radioactive iodine (RAI) therapy and risk of SPCs following DTC remains widely debated. 12 This association has suggested an enhanced SPC risk for both solid tumors and leukemia in patients with RAI-treated DTC compared with DTC survivors not exposed to RAI, mainly in younger patients.…”

“…According to the National Cancer Institute's Surveillance, Epidemiology and End Results Program, cancers with the best survival rates are breast, Hodgkin's lymphoma, melanoma, prostate, testicular, and differentiated thyroid cancer (DCT), which all have a 5‐year survival rate of >85% (the 10‐year survival rate for papillary thyroid carcinoma [PTC] is 95–99%) 6 . Because of the high cure rates, most of these patients will survive having cancer, and will therefore be at increased risk for development of a second primary cancer (SPC), with a lifetime risk as high as 37% 4,5 …”

“…The prevalence of MPMN is reported to be 2%–17%. 3 , 4 , 5 It is expected that the prevalence of MPMN (mainly metachronous) will increase in the future due to increasingly aging populations combined with improved cancer survival, improved diagnostic tests, increasingly sophisticated treatment, better screening, and enhanced surveillance of patients with previous cancer. 3 …”

“…6 Because of the high cure rates, most of these patients will survive having cancer, and will therefore be at increased risk for development of a second primary cancer (SPC), with a lifetime risk as high as 37%. 4 , 5 …”

“…6 Because of the high cure rates, most of these patients will survive having cancer, and will therefore be at increased risk for development of a second primary cancer (SPC), with a lifetime risk as high as 37%. 4,5 DTC is the most common endocrine malignancy, accounting for approximately 0.5%-1.5% of all cases (in adulthood and childhood) and more than 90% of all the thyroid cancers and malignancies of the endocrine system. The most common DTC is PTC.…”