Selective use of sorafenib in the treatment of thyroid cancer
Open Access
- 1 March 2016
- journal article
- review article
- Published by Taylor & Francis Ltd in Drug Design, Development and Therapy
- Vol. ume 10, 1119-1131
- https://doi.org/10.2147/DDDT.S82972
Abstract
Selective use of sorafenib in the treatment of thyroid cancer Fabián Pitoia, Fernando Jerkovich Division of Endocrinology, Hospital de Clinicas – University of Buenos Aires, Buenos Aires, Argentina Sorafenib is a multiple kinase inhibitor (MKI) approved for the treatment of primary advanced renal cell carcinoma and advanced primary liver cancer. It was recently approved by several health agencies around the world as the first available MKI treatment for radioactive iodine-refractory advanced and progressive differentiated thyroid cancer. Sorafenib targets C-RAF, B-RAF, VEGF receptor-1, -2, -3, PDGF receptor-β, RET, c-kit, and Flt-3. As a multifunctional inhibitor, sorafenib has the potential of inhibiting tumor growth, progression, metastasis, and angiogenesis and downregulating mechanisms that protect tumors from apoptosis and has shown to increase the progression-free survival in several Phase II trials. This led to the Phase III trial (DECISION) which showed that there was an improvement in progression-free survival of 5 months for patients on sorafenib when compared to those on placebo. Adverse events with this drug are common but usually manageable. The development of resistance after 1 or 2 years is almost a rule in most patients who showed partial response or stabilization of the disease while on sorafenib, which makes it necessary to think of a plan for subsequent therapies. These may include the use of another MKI, such as lenvatinib, the second approved MKI for advanced differentiated thyroid cancer, or include patients in clinical trials or the off-label use of other MKIs. Given sorafenib’s earlier approval, most centers now have access to its prescription. The goal of this review was to improve the care of these patients by describing key aspects that all prescribers will need to master in order to optimize outcomes. Keywords: multiple kinase inhibitor, differentiated thyroid cancer, progression-free survival, radioiodineKeywords
This publication has 83 references indexed in Scilit:
- THERAPY OF ENDOCRINE DISEASE: Response and toxicity of small-molecule tyrosine kinase inhibitors in patients with thyroid carcinoma: a systematic review and meta-analysisActa Endocrinologica, 2015
- Thyroid Carcinoma, Version 2.2014Journal of the National Comprehensive Cancer Network, 2014
- Clinical outcomes and molecular profile of differentiated thyroid cancers with radioiodine-avid distant metastases.Journal of Clinical Endocrinology & Metabolism, 2013
- BRAFV600EMutation and Papillary Thyroid Cancer: Chicken or Egg?Journal of Clinical Endocrinology & Metabolism, 2012
- Meta-Analysis of Randomized Controlled Trials for the Incidence and Risk of Treatment-Related Mortality in Patients With Cancer Treated With Vascular Endothelial Growth Factor Tyrosine Kinase InhibitorsJournal of Clinical Oncology, 2012
- Inhibition of the Ras/Raf/MEK/ERK and RET Kinase Pathways with the Combination of the Multikinase Inhibitor Sorafenib and the Farnesyltransferase Inhibitor Tipifarnib in Medullary and Differentiated Thyroid MalignanciesJournal of Clinical Endocrinology & Metabolism, 2011
- Sorafenib and SunitinibThe Oncologist, 2009
- BRAF Mutation in Papillary Thyroid Cancer: Pathogenic Role, Molecular Bases, and Clinical ImplicationsEndocrine Reviews, 2007
- BAY 43-9006 Exhibits Broad Spectrum Oral Antitumor Activity and Targets the RAF/MEK/ERK Pathway and Receptor Tyrosine Kinases Involved in Tumor Progression and AngiogenesisCancer Research, 2004
- Challenging Dogma in Thyroid Cancer Molecular Genetics—Role ofRET/PTCandBRAFin Tumor InitiationJournal of Clinical Endocrinology & Metabolism, 2004