Molekular zielgerichtete Therapien beim radiojodrefraktären differenzierten Schilddrüsenkarzinom – Update 2022

Köhler, Viktoria F.; Westphalen, C. Benedikt; Nagarajah, James; Zacherl, Mathias und Spitzweg, Christine (2022): Molekular zielgerichtete Therapien beim radiojodrefraktären differenzierten Schilddrüsenkarzinom – Update 2022. In: Onkologie, Bd. 28, Nr. 8: S. 649-659

Abstract

Background The individualized use of systemic molecularly targeted therapies in radioiodine refractory differentiated thyroid cancer (DTC) should be limited to patients with large tumor burden and progressive, metastatic disease that is not amenable to other local palliative approaches or a watch and wait strategy. In addition to the two approved multityrosine kinase inhibitors lenvatinib and sorafenib, cabozantinib has recently been approved for second-line treatment. The identification of specific gene alterations, such as BRAF(V600E) mutation, RET or NTRK fusions as well as ALK fusions allows the very effective use of the respective selective inhibitors within tumor-agnostic approval or off-label use, or if available preferably within a clinical trial. The specific targeting of driver mutations has also been demonstrated to very effectively re-induce tumoral radioiodine uptake thereby re-establishing radioiodine therapy that has been successfully used in DTC for more than 80 years. Conclusion In order to make use of targetable mutations within an individualized therapy concept, we highly recommend timely molecular analysis of tumor tissue in patients with radioiodine refractory DTC. Patients with advanced radioiodine refractory DTC should be referred to experienced centers that offer interdisciplinary expertise in the individualization of treatment including participation in clinical trials.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 2731-7226
• Sprache: Deutsch