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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
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Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
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Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...
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Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
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Thyroid carcinoma, version 2.2014.

R Michael Tuttle1, Robert I Haddad1, Douglas W Ball1

  • 1From Memorial Sloan Kettering Cancer Center; Dana-Farber/Brigham and Women's Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; University of Washington/Seattle Cancer Care Alliance; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center; UCSF Helen Diller Family Comprehensive Cancer Center; Fox Chase Cancer Center; University of Michigan Comprehensive Cancer Center; UC San Diego Moores Cancer Center; Huntsman Cancer Institute at the University of Utah; Stanford Cancer Institute; City of Hope Comprehensive Cancer Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Roswell Park Cancer Institute; Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; Moffitt Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Vanderbilt-Ingram Cancer Center; University of Colorado Cancer Center; The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute; Duke Cancer Institute; The University of Texas MD Anderson Cancer Center; University of Alabama at Birmingham Comprehensive Cancer Center; Massachusetts General Hospital Cancer Center; and National Comprehensive Cancer Network.

Journal of the National Comprehensive Cancer Network : JNCCN
|December 16, 2014
PubMed
Summary
This summary is machine-generated.

New NCCN Guidelines offer updated recommendations for advanced thyroid carcinoma treatment. Kinase inhibitors like sorafenib, vandetanib, and cabozantinib are now options for specific metastatic thyroid cancer cases.

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Area of Science:

  • Oncology
  • Pharmacology

Background:

  • The National Comprehensive Cancer Network (NCCN) Guidelines provide essential updates for thyroid carcinoma management.
  • Radioactive iodine is a standard treatment, but advanced or symptomatic cases require alternative therapies.

Purpose of the Study:

  • To summarize key updates in the 2014 NCCN Guidelines for Thyroid Carcinoma.
  • To highlight the role of novel kinase inhibitor therapies in advanced thyroid cancer.

Main Methods:

  • Review of the 2014 NCCN Guidelines for Thyroid Carcinoma.
  • Identification of new recommendations for systemic therapy in advanced disease.

Main Results:

  • Kinase inhibitor therapy is recommended for symptomatic and/or progressive thyroid carcinoma unresponsive to radioactive iodine.
  • Sorafenib is considered for metastatic differentiated thyroid carcinoma.
  • Vandetanib or cabozantinib are recommended for metastatic medullary thyroid carcinoma.
  • Other kinase inhibitors may be considered for select patients.

Conclusions:

  • The NCCN Guidelines now include a dedicated section on "Principles of Kinase Inhibitor Therapy in Advanced Thyroid Cancer."
  • These targeted agents represent a significant advancement in treating advanced thyroid carcinoma.