PD2-1 - Will molecular-targeted agents change clinical practice for advanced thyroid cancer?

Abstract

The pharmaceutical therapy to malignant tumor has recently been changed to the strategy centering on the molecular-targeted agents and advanced or metastatic thyroid cancer is no exception. In Japan, Sorafenib was approved for treatment of radioiodine refractory differentiated thyroid cancer (DTC), and treatment strategy for the advanced or metastatic DTC is at an inflection point.However, as the DTC often shows indolent course, the indication of the molecular-targeted agents to the patients with advanced DTC should be carefully decided (i.e. when and what state of condition of DTC the molecular-targeted agents should be administered to). Moreover, the importance of monitoring and management of adverse effects caused by molecular-targeted agents is emphasized. To provide the most benefit to the patients with advanced or metastatic DTC, we should select the appropriate patients on the basis of knowledge about biology of thyroid cancer, and then the molecular-targeted agents should be administered after careful consideration of the balance between potential benefits and harm. On the other hand, the importance of appropriate surgical treatment of DTC is increasingly being highlighted with the advent of molecular-targeted agents. As the patient should have had an appropriate surgery to evaluate the refractoriness to the conventional radioiodine therapy adequately, the role of thyroid surgeon becomes important more than ever. In addition, careful attention to the symptoms caused by enlargement or anaplastic transformation of the tumor is required in the treatment of advanced DTC. From now on, it would be important for the medical team to develop the treatment strategy for advanced or metastatic thyroid cancer based on a shared understanding of biology of thyroid cancer.