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Review
. 2020 Aug 4;12(8):2164.
doi: 10.3390/cancers12082164.

Molecular Markers Guiding Thyroid Cancer Management

Carolina Nylén  1   2 , Robert Mechera  1   3 , Isabella Maréchal-Ross  4 , Venessa Tsang  4   5 , Angela Chou  4   6 , Anthony J Gill  4   6 , Roderick J Clifton-Bligh  4   5   7 , Bruce G Robinson  4   5   7 , Mark S Sywak  1   4 , Stan B Sidhu  1   4   7 , Anthony R Glover  1   4   8
Affiliations
Review

Molecular Markers Guiding Thyroid Cancer Management

Carolina Nylén et al. Cancers (Basel). .

Abstract

The incidence of thyroid cancer is rapidly increasing, mostly due to the overdiagnosis and overtreatment of differentiated thyroid cancer (TC). The increasing use of potent preclinical models, high throughput molecular technologies, and gene expression microarrays have provided a deeper understanding of molecular characteristics in cancer. Hence, molecular markers have become a potent tool also in TC management to distinguish benign from malignant lesions, predict aggressive biology, prognosis, recurrence, as well as for identification of novel therapeutic targets. In differentiated TC, molecular markers are mainly used as an adjunct to guide management of indeterminate nodules on fine needle aspiration biopsies. In contrast, in advanced thyroid cancer, molecular markers enable targeted treatments of affected signalling pathways. Identification of the driver mutation of targetable kinases in advanced TC can select treatment with mutation targeted tyrosine kinase inhibitors (TKI) to slow growth and reverse adverse effects of the mutations, when traditional treatments fail. This review will outline the molecular landscape and discuss the impact of molecular markers on diagnosis, surveillance and treatment of differentiated, poorly differentiated and anaplastic follicular TC.

Keywords: Genomics; indeterminate nodules; molecular testing; personalized medicine; surgery; targeted therapy; thyroid cancer; tyrosine kinase inhibitors.

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Conflict of interest statement

B.G.R. reports personal fees from Loxo Oncology, outside the submitted work. B.G.R., R.J.C.-B., and V.T. report personal fees from Eisai, outside the submitted work. The remaining authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Figures

Figure 1
Figure 1
Molecular landscape in thyroid cancer.
Figure 2
Figure 2
Illustration of the oncogenesis mode.
Figure 3
Figure 3
Histopathology and images of case report described in Box 1. (a) Haematoxylin and eosin stain of tumour, (b) BRAFV600E stain of tumour, (c) PET scan at initial presentation, (d) CT at initial presentation, (e) CT after one month of daily Lenvatinib 20mg treatment and 50Gy external beam radiation.
Figure 4
Figure 4
Suggested flow chart of use of molecular testing in advanced thyroid cancer.
See this image and copyright information in PMC

References

    1. Bray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. Global cancer statistics 2018: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018;68:394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Seib C.D., Sosa J.A. Evolving understanding of the epidemiology of thyroid cancer. Endocrinol. Metab. Clin. N. Am. 2019;48:23–35. doi: 10.1016/j.ecl.2018.10.002. - DOI - PubMed
    1. Davies L., Welch H.G. Current thyroid cancer trends in the united states. JAMA Otolaryngol. Head. Neck. Surg. 2014;140:317–322. doi: 10.1001/jamaoto.2014.1. - DOI - PubMed
    1. Rahib L., Smith B.D., Aizenberg R., Rosenzweig A.B., Fleshman J.M., Matrisian L.M. Projecting cancer incidence and deaths to 2030: The unexpected burden of thyroid, liver, and pancreas cancers in the united states. Cancer Res. 2014;74:2913–2921. doi: 10.1158/0008-5472.CAN-14-0155. - DOI - PubMed
    1. Howlader N., Noone A., Krapcho M., Miller D., Bishop K., Altekruse S.F., Kosary C.L., Yu M., Ruhl J., Tatalovich Z., et al., editors. Seer Cancer Statistics Review, 1975–2013. National Cancer Institute; Bethesda, MD, USA: 2015. [(accessed on 14 May 2020)]. Available online: https://seer.cancer.gov/archive/csr/1975_2013/

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