Abstract
We present a patient with respiratory insufficiency due to progressive lung metastases of thyroid cancer. Low dose i.v. vinblastin, oral cyclophosphamide and s.c. enoxaparin produced dramatic clinical improvement, a drop in thyroglobulin and prolonged disease stabilisation. This new way of giving classical chemotherapy is called metronomic chemotherapy. Its anti-angiogenic basis of activity is corroborated by the more recent drugs in thyroid cancer which share this mechanism.
Highlights
There was no effective chemotherapy for iodine refractory thyroid cancer
The use of lower dose chemotherapy like in other endocrine responsive tumors was never evaluated in this tumor type
A rise in thyroglobulin and increase in size of lung metastasis were treated with two doses of 150 mCi I* in 2005
Summary
There was no effective chemotherapy for iodine refractory thyroid cancer. The clinical benefit, as well as the prolonged disease stabilisation by metronomic chemotherapy in a palliative patient with massive lung metastases, illustrates empirically the anti-angiogenic effect of this type of chemotherapy. It predated the recent avalanche of specific angiogenesis inhibitors in this disease. Our patient first presented at the age of 55 with a large mediastinal mass in 2000 After resection this proved to be a follicular thyroid adenocarcinoma weighing 270 grams. The patient, 63 years, was referred to a tertiary cancer centre to participate in a phase II trial with a new tyrosine kinase inhibitor This protocol was closed and the patient was treated with sandostatin injections.
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