Tyrosine kinase inhibitors as a strategy to treat differentiated thyroid cancer

Afarin Aghajari,1,* Mohammad amin dehghani ,2 Fatemeh dehghani ,3

1. School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2. Student Research Committee of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
3. Department of Genetics, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Introduction

Differentiated thyroid cancer (dtc) as a indolent tumor is responsible for 95% of whole thyroid cancers, whose therapeutic strategies are surgery, radioactive iodine, and thyroid-stimulating hormone suppressive therapy. recent available molecular targets, especially tyrosine kinase inhibitors (tkis), sorafenib and lenvatinib, have been approved for iodine refractory dtc with beneficial due to progression-free survival and without efficacy on overall survival.

Methods

Pubmed database was used to search related articles in english with the aid of keywords including dtc, tyrosine kinase inhibitors, clinical trials and cancer therapeutics.

Results

The studies on dtc are ongoing are multiple tkis, multi-targeted or specific. the present study was conducted to introduce reports on targeted therapies in dtc, including the reasons, clinical trials and expert views regarding their applications. according to a phase iii trial (decision) of sorafenib in radioiodine (rai)-refractory thyroid cancer, a median progression-free survival (pfs) was 10.8 months in the sorafenib group compared to in the placebo group (5.8 months). a significant anti-tumor effect was reported for sunitinib, a type of tki, in patients with advanced dtc. the total response rate of patients receiving lenvatinib was 64.8%, in a central phase iii study on 392 patients with progressive radioiodine-refractory thyroid cancer, as four patients had complete response. the lenvatinib arm showed median progression-free survival of 18.3 months compared to 3.6 months in placebo-receiving patients.

Conclusion

Further research is required to evaluate the common complications from tki therapy. there is need for a well-adjusted balance between efficacy and adverse impacts. the first agents with activity in advanced medullary thyroid cancers have been approved by findings capable of altering therapeutic landscape for iodine-refractory dtc.

Keywords

Dtc, tyrosine kinase inhibitors, clinical trials, cancer therapeutics.