Fosbretabulin tromethamine in the treatment of thyroid cancer

Abstract

ABSTRACTIntroduction: Anaplastic thyroid carcinoma [ATC] is a rare, highly aggressive neoplasm with a disease-specific mortality of nearly 100%. Available treatment options include surgery, radiotherapy, chemotherapy or their combination and, more often recently, participation in clinical trials, as recommended by all available guidelines. However, despite of many attempts with the use of new targeted drugs, to date no remarkable progress in the improvement in patients’ survival has been made. Fosbretabulin (combretastatin A4 phosphate, CA4P) is a vascular disrupting agent, and a new drug that targets tumor neovasculature leading to an acute, reversible reduction in tumor blood flow and tumor central necrosis. Its activity against ATC was evaluated in the FACT trial.Areas covered: Published results of preclinical, phase I and II studies, and other reports evaluating the mechanism of action, efficacy and safety of fosbretabulin alone or combination with other drugs in ATC are evaluated.Expert Opinion: Disappointing results of previous randomized studies, referred to ATC treatment, force us to draw conclusions. Among the reasons leading to the failure of FACT study was an insufficient number of enrolled patients. Since available guidelines emphasized the necessity to treat ATC under clinical trials, inclusion criteria should be reconsidered to make the recruitment process much easier and faster in future.