Personalized treatment options for thyroid cancer: current perspectives

Abstract

Thyroid cancer is one of the most common endocrine malignancies, with increasing incidence all over the world. In spite of good prognosis for differentiated thyroid carcinoma, for an unknown reason, about 5-10% of the patients, the cancer will show aggressive behavior, develop metastasis, and be refractory to treatment strategies like radioactive iodine. Regarding the genetic information, each thyroid cancer patient can be considered as an individual unique one, with unique genetic information. Contrary to standard chemotherapy drugs, target therapy components aim at one or more definite molecular pathway on cancer cells, so their selection is underlying patient's genetic information. Nowadays, several mutations and rearrangements including BRAF, VEGF receptors, RET, and RET/PTC, KDR, KIT, PDGFRA, CD274, and JAK2 are taken into account for the therapeutic components like larotrectinib (TRK inhibitor), vemurafenib, sunitinib, sorafenib, selumetinib, and axitinib. With the new concept of personalized treatment of thyroid cancer diagnoses, planning treatment, finding out how well treatment will work, and estimating a prognosis has changed for the better over the last decade.

Keywords: molecular testing; personalized medicine; target therapy.

Figure 1

Several small molecules are valid for thyroid cancer target therapies. These molecules can be categorized as the molecules targeting oncogenic kinases, signaling kinases, and vasculature and angiogenesis process. More than these molecules there are some other types of molecules which targeting epigenetic mechanisms (Fosbretabulin, Romidepsin, Celecoxib, Vorinostat, Valproic acid, Azacytidine, and Decitabine) or nuclear receptors.