Predictors of Response and Survival to Multikinase Inhibitors in Radioiodine Resistant Differentiated Thyroid Cancer

Sorafenib and lenvatinib are the only multikinase inhibitors (MKIs) approved for the treatment of radioactive iodine refractory differentiated thyroid cancer (RR-DTC). Although they have been demonstrated to improve progression free survival and overall response rate, the risk of toxicities is very...

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Veröffentlicht in:Journal of personalized medicine 2021-07, Vol.11 (7), p.674
Hauptverfasser: Feola, Tiziana, Cozzolino, Alessia, Centello, Roberta, Pandozzi, Carla, Tarsitano, Maria Grazia, Giannetta, Elisa
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container_issue 7
container_start_page 674
container_title Journal of personalized medicine
container_volume 11
creator Feola, Tiziana
Cozzolino, Alessia
Centello, Roberta
Pandozzi, Carla
Tarsitano, Maria Grazia
Giannetta, Elisa
description Sorafenib and lenvatinib are the only multikinase inhibitors (MKIs) approved for the treatment of radioactive iodine refractory differentiated thyroid cancer (RR-DTC). Although they have been demonstrated to improve progression free survival and overall response rate, the risk of toxicities is very high, worsening patients’ quality of life. Therefore, predicting MKI treatment outcomes in the setting of RR-DTC is very challenging for optimizing patients’ management. The current review provides an overview of the predictive factors for the response and survival of sorafenib and lenvatinib in RR-DTC. In this setting, a systemic therapy should be considered after conducting a multidisciplinary discussion aimed at evaluating the risk-benefit ratio of the treatment and taking into account several clinical, biochemical, and molecular factors. Age, performance status, and cancer-related symptoms are the most important clinical markers to be considered prior to starting MKI treatment, together with tumor burden. Some tissue and circulating biomarkers have been investigated, those involved in the angiogenic pathways being the most promising. Finally, prospective clinical trials aimed at evaluating predictive markers for therapeutic response are needed for tailoring patient management and allowing more appropriate treatment choices.
doi_str_mv 10.3390/jpm11070674
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subjects Angiogenesis
Biomarkers
Clinical trials
Disease control
Drug dosages
FDA approval
Genotype & phenotype
Iodine
Medical prognosis
Metastasis
Patients
Precision medicine
Quality of life
Response rates
Review
Survival
Thyroid cancer
Vascular endothelial growth factor
title Predictors of Response and Survival to Multikinase Inhibitors in Radioiodine Resistant Differentiated Thyroid Cancer
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