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Spontaneous Murine Model of Anaplastic Thyroid Cancer
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Update on multikinase inhibitor therapy for differentiated thyroid cancer
V R Agrawal1, G Jodon2, R Mushtaq3
1Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Abstract:
Curative therapies for radioiodine-refractory differentiated thyroid cancer remain lacking. However, oral multikinase inhibitors often allow for disease control and improved progression-free survival. Two agents, lenvatinib and sorafenib, have been approved for radioiodine-refractory differentiated thyroid cancer on the basis of phase III clinical trials showing marked response rates and improved progression-free survival over placebo. Several other multikinase inhibitors, including apatinib, axitinib, cabozantinib, pazopanib, sunitinib and vandetanib, have also been studied in phase II clinical trials, with varying response rates and comparable progression-free survival. Selective kinase inhibitors, including dabrafenib, vemurafenib, selumetinib and gefitinib, offer a more targeted approach and have also been studied in phase II clinical trials. While the emergence of these treatments has changed the landscape of management of advanced thyroid cancer, clinical challenges remain, and there are many areas of ongoing research.
Insights
Oral multikinase inhibitors offer disease control for radioiodine-refractory differentiated thyroid cancer. Approved agents like lenvatinib and sorafenib improve progression-free survival, with ongoing research for advanced thyroid cancer treatments.
Area of Science:
- Oncology
- Pharmacology
Background:
- Radioiodine-refractory differentiated thyroid cancer lacks curative therapies.
- Oral multikinase inhibitors represent a significant advancement in managing this condition.
Purpose of the Study:
- To review the efficacy of approved and investigational multikinase inhibitors for radioiodine-refractory differentiated thyroid cancer.
- To highlight the impact of these targeted therapies on disease control and progression-free survival.
Main Methods:
- Review of phase III clinical trials for approved agents (lenvatinib, sorafenib).
- Analysis of phase II clinical trial data for other multikinase inhibitors (apatinib, axitinib, cabozantinib, pazopanib, sunitinib, vandetanib) and selective kinase inhibitors (dabrafenib, vemurafenib, selumetinib, gefitinib).
Main Results:
- Lenvatinib and sorafenib demonstrated marked response rates and improved progression-free survival in phase III trials.
- Various other multikinase inhibitors showed comparable progression-free survival in phase II studies.
- Selective kinase inhibitors offer targeted approaches with varying response rates.
Conclusions:
- Multikinase inhibitors have transformed the management of advanced differentiated thyroid cancer.
- Despite progress, clinical challenges persist, necessitating continued research in novel therapeutic strategies.
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