Protein kinase inhibitors for the treatment of advanced and progressive radiorefractory thyroid tumors: From the clinical trials to the real life

Best Pract Res Clin Endocrinol Metab. 2017 Jun;31(3):319-334. doi: 10.1016/j.beem.2017.06.001. Epub 2017 Jun 15.

Abstract

The last ten years have been characterized by the introduction in the clinical practice of new drugs named tyrosine kinase inhibitors for the treatment of several human tumors. After the positive conclusion of two international multicentric, randomized phase III clinical trials, two of these drugs, sorafenib and lenvatinib, have been recently approved and they are now available for the treatment of advanced and progressive radioiodine refractory thyroid tumors. We have been involved in most clinical trials performed with different tyrosine kinase inhibitors in different histotypes of thyroid cancer thus acquiring a lot of experience in the management of both drugs and their adverse events. Aim of this review is to give an overview of both the rationale for the use of these inhibitors in thyroid cancer and the major results of the clinical trials. Some suggestions for the management of treated patients in the real life are also provided.

Keywords: RECIST; oncogenes; protein kinases; thyroid carcinoma; vascular endothelial growth factor.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Chemotherapy, Adjuvant
  • Clinical Trials as Topic* / statistics & numerical data
  • Humans
  • Iodine Radioisotopes / therapeutic use*
  • Niacinamide / analogs & derivatives
  • Niacinamide / therapeutic use
  • Phenylurea Compounds / therapeutic use
  • Practice Patterns, Physicians'* / statistics & numerical data
  • Protein Kinase Inhibitors / therapeutic use*
  • Quinolines / therapeutic use
  • Sorafenib
  • Thyroid Neoplasms / drug therapy*
  • Thyroid Neoplasms / mortality
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / radiotherapy*
  • Treatment Failure

Substances

  • Antineoplastic Agents
  • Iodine Radioisotopes
  • Phenylurea Compounds
  • Protein Kinase Inhibitors
  • Quinolines
  • Niacinamide
  • Sorafenib
  • lenvatinib