Targeted drug therapy
Targeted therapy refers to drug treatments that are designed to attack faulty signalling mechanisms in thyroid cancer cells. These drugs are also called tyrosine kinase inhibitors (TKIs) or multikinase inhibitors (MKIs). A number of different drugs have been studied in thyroid cancer patients with papillary, follicular and medullary thyroid cancer. The drugs include sorafenib (NexavarR), lenvatinib (LenvimaR), vandetanib (CaprelsaR) and cabozantinib (CometriqR).
Some of these are now available for use when thyroid cancer has spread to other parts of the body, is growing and is associated with troublesome symptoms. These drugs are not universally available and are not suitable for everyone. Your doctor will talk to you about any suitable options.
These drugs are given in tablet form on a daily basis and may be taken continuously for months to years if they are being tolerated and there is evidence of benefit.
All of these drugs are associated with side effects and the severity can vary markedly between people. Some patients may have other medical conditions or be taking medications that make targeted therapy drugs unsuitable.
Some of these drugs are not yet available either because the final results from the clinical studies are not yet known or because the drug has not yet been granted a license for use. This area is changing quite quickly so check the up to date situation with your thyroid cancer specialist.
New drugs or existing drugs used in different ways may be available through clinical trials. Not all cancer centres can offer these clinical trials but it is common practice for patients to be referred on to the nearest participating centre if they wish to be considered for these reserach studies.
Papillary, follicular, medullary thyroid cancer:
Conventional chemotherapy, like that used for many of the more common cancers is rarely used for these types of thyroid cancer.
Drugs like cisplatin and doxorubicin have been used but the benefits are often small and short lived.
Anaplastic thyroid cancer:
Chemotherapy might be considered in two different settings.
The first is for those patients who have undergone a thyroidectomy and removal of the vast majority of their cancer. This type of surgery may be followed by a prolonged course of radiotherapy and some patients may be considered for a combination of radiotherapy with chemotherapy. This is very tough treatment and isn't suitable for many patients.
The second is for those patients with more extensive disease where the aim is to try and help improve symptoms. It is however important to balance the cancer symptoms against the potential side effects of the chemotherapy when trying to decide if this treatment may be helpful.
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Thyroid Cancer Forum UKDr. Kate Garcez
Christie NHS Foundation Trust, Manchester, M20 4BX
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