Abstract
Thyroid cancer is the most common endocrine malignancy. Most thyroid cancer types respond well to conventional treatment consisting of surgery and radioactive iodine (RAI) therapy. Unfortunately, some thyroid cancer types are resistant to surgical and RAI therapy. Multikinase inhibitors (MKIs) can be used in the treatment of advanced refractory thyroid cancers. The objective of this review is to give an update on MKI treatment (lenvatinib, sorafenib, sunitinib, cabozantinib, pazopanib, vandetanib) of thyroid cancer, regarding its efficacy and safety profile. We evaluated 212 articles through a PubMed search. A total of 20 articles met the inclusion and none the exclusion criteria. The studies showed promising progression-free survival rates compared to placebo treatment from earlier studies and similar or better results compared to the SELECT and DECISION trials. Adverse effects (AEs) are substantial in the treatment with MKIs. Almost all patients treated with these novel drugs experienced AEs. It is therefore crucial to focus on the management of AEs for a decent long-term outcome. The AEs are often more severe in patients with high efficacy of MKIs, which could indicate a correlation. Taken together, the novel therapeutic regimen with MKIs has shown favorable results in otherwise treatment-resistant thyroid cancer.
Highlights
Thyroid cancer is the most common endocrine cancer, affecting women in approximately 75% of cases [1]
Most thyroid cancer types respond well to conventional treatment consisting of surgery and radioactive iodine (RAI) therapy
The objective of this review is to give an update on Multikinase inhibitors (MKIs) treatment of thyroid cancer, regarding its efficacy and safety profile
Summary
Thyroid cancer is the most common endocrine cancer, affecting women in approximately 75% of cases [1]. Thyroid cancer accounts for about 550,000 cases per year worldwide. The global incidence rate is 10.2 per 100,000 among women, whereas it is 3.1 per 100,000 for men. In the last 30 years, an increase in new cases of thyroid cancer has been seen almost all over the world. Even though the incidence rate of thyroid cancer is increasing, the mortality rate is more stable [3]. The steady mortality rate may be due to the current treatment possibilities available for thyroid cancer. In Denmark, the treatment of thyroid cancer is a highly specialized task. For most thyroid cancer cases, the first choice, often together with radioactive iodine (RAI) as an adjuvant treatment [4]
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