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Published on: June 2, 2023
Overview and management of dermatologic events associated with targeted therapies for medullary thyroid cancer
Mario E Lacouture1, Kathryn Ciccolini, Richard T Kloos
11 Dermatology Service, Memorial Sloan-Kettering Cancer Center , New York, New York.
Background:
Treatment options for patients with advanced or metastatic medullary thyroid cancer (MTC) have, in recent years, expanded with the approval of two tyrosine kinase inhibitors (TKIs): vandetanib and cabozantinib. Other agents, including TKIs, are under clinical investigation for MTC. Although patients treated with TKIs are at risk of developing dermatologic adverse events (AE), these untoward events may be mitigated through AE-driven algorithms.
Summary:
AE-driven algorithms combine effective nonpharmaceutical and pharmaceutical treatment modalities implemented by a multidisciplinary effort that incorporates nursing interventions, patient education, and referrals to pain-management specialists, podiatrists, and dermatologists, as appropriate. Effective AE prevention and management reduce the need for dose interruptions and modifications, allowing patients the opportunity to derive the maximal benefit from TKI therapy, while maintaining quality of life.
Conclusions:
Optimal use of targeted therapies in the treatment of MTC depends on careful patient selection, interdisciplinary communication, and patient education and encouragement to enhance compliance and safety, optimize consistent dosing, and maximize the use of effective therapies.
Insights
Dermatologic adverse events (AEs) from tyrosine kinase inhibitors (TKIs) for advanced medullary thyroid cancer (MTC) can be managed. AE-driven algorithms improve patient outcomes and quality of life during TKI therapy.
Area of Science:
- Oncology
- Pharmacology
- Dermatology
Background:
- Advanced or metastatic medullary thyroid cancer (MTC) treatment options have expanded with new tyrosine kinase inhibitors (TKIs).
- TKIs like vandetanib and cabozantinib are approved for MTC, with others in clinical trials.
- Patients receiving TKIs are susceptible to dermatologic adverse events (AEs).
Purpose of the Study:
- To outline strategies for mitigating dermatologic adverse events associated with TKI therapy in MTC.
- To emphasize the importance of AE management for optimizing TKI treatment efficacy and patient quality of life.
Main Methods:
- Implementation of AE-driven algorithms.
- Multidisciplinary approach involving nursing, patient education, and specialist referrals (pain management, podiatry, dermatology).
- Combination of nonpharmaceutical and pharmaceutical treatment modalities.
Main Results:
- Effective AE prevention and management reduce TKI dose interruptions and modifications.
- Allows patients to achieve maximal benefit from TKI therapy.
- Contributes to maintaining patient quality of life during treatment.
Conclusions:
- Optimal use of targeted therapies in MTC requires careful patient selection and interdisciplinary communication.
- Patient education and encouragement are crucial for enhancing compliance and safety.
- Consistent dosing and maximizing therapeutic benefit are key goals in MTC management.
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