Treatment of medullary thyroid carcinoma: an update.

Abstract

Prognosis and treatment effectiveness of medullary thyroid carcinoma (MTC) are largely related to the tumour stage, so that early diagnosis represents an important goal for the management of patients. Recent advances in genetic testing have improved the clinical approach to the familial MTC syndromes. There is general agreement that the primary operation for MTC should obtain the complete removal of the neoplastic tissue in the neck, because any adjuvant treatment has never been proven to be effective. The management of residual/recurrent or metastatic MTC still remains controversial, although a multimodal approach to advanced disease may be of value in palliation or local control of tumour progression. The role of surgery, external radiotherapy, radionuclide therapy and medical treatment, including biological response modifiers and cytotoxic drugs, are reviewed and discussed.

Antisurvivin oligonucleotides inhibit growth and induce apoptosis in human medullary thyroid carcinoma cells

“…At present, therapy for MTC is mostly restricted to surgical removal of the tumor tissue, but residual MTC can be detectable in 56% of patients after surgery owing to the early metastatic nature of MTC (Evans et al, 1999;Orlandi et al, 2001). In MTC, objective responses to other forms of therapy such as chemotherapy and radiotherapy are mostly insufficent, fewer than 20% (Petursson, 1988;Samaan et al, 1988;Wu et al, 1994;Brierley et al, 1996;Vitale et al, 2001).…”

Primary RET-mutated lung neuroendocrine carcinoma in MEN2B: response to RET-targeted therapy

“…In MEN2, prophylactic thyroidectomy is recommended for family members who carry the germline mutation, ideally within the first year of life in patients with MEN2B due to the high penetrance, morbidity, and mortality of MTC associated with the M918T mutation (Skinner et al 2005). Standard cytotoxic chemotherapy and radiotherapy are not effective in MTC (Orlandi et al 2001); however, novel targeted therapies have been developed that inhibit the activated RET RTK, including cabozantinib .…”

Fifteen-year treatment of metastatic thyroid medullary carcinoma: a case report

“…If metastases are large and located in areas that are easy to remove, they should be removed surgically Discussion [5,6]. Other treatment options, such as radiation treatment, chemotherapy and embolization, are applied for patients for whom surgery is not an option [7,8].…”

“…Success rates of cytotoxic chemotherapy are quite low in metastatic MTC and rates varying between 2 and 25% are reported [8]. Doxorubicin has been the most frequently reported agent with a response rate probably not higher than 15-20%, all responses being partial and transient and with high toxicities [8]. Combination of doxorubicin with other drugs such as cisplatin [10], or streptozocin [11] did not increase the response rate.…”