Papillary thyroid cancer medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Papillary thyroid cancer}} | {{Papillary thyroid cancer}} | ||
{{CMG}}; {{AE}} {{Ammu}} | {{CMG}}; {{AE}} {{Sahar}} {{Ammu}} | ||
==Overview== | ==Overview== | ||
Treatment options for papillary thyroid cancer differes according to the [[stage]] and [[invasion]] of the [[tumor]] and include [[surgery]], [[external beam radiation therapy]] ( [[external beam radiation therapy|EBRT]]), Thyroid suppression therapy, and targeted therapy. | |||
==Medical Therapy== | ==Medical Therapy== | ||
=== | * Treatment options for papillary thyroid cancer include:<ref name="urlThyroid Cancer Treatment (Adult) (PDQ®)–Health Professional Version - National Cancer Institute">{{cite web |url=https://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq#link/_676 |title=Thyroid Cancer Treatment (Adult) (PDQ®)–Health Professional Version - National Cancer Institute |format= |work= |accessdate=}}</ref> | ||
{{familytree/start}} | |||
{{familytree | | | | | | | | | A01 | | | | | | | | |A01=Papillary thyroid cnacer treatment}} | |||
=== | {{familytree | | |,|-|-|-|-|-|-|+|-|-|-|-|-|-|.| }} | ||
* | {{familytree | | B01 | | | | | B02 | | | | | B03 |B01=Localized or regional [[tumor]]|B02=[[Metastatic]]|B03=Recurrent}} | ||
{{familytree | | |!| | | | | | |!| | | | | | |!| | }} | |||
=== | {{familytree | | C01 | | | | | |!| | | | | | C03 |C01=[[Surgery]]<br>Total [[thyroidectomy]]<br>Lobectomy<br>[[Radioactive iodine uptake|RAI therapy]]<br>Thyroid suppression therapy<br>[[External beam radiation therapy|EBRT]]|C03=[[Surgery]] ± postoperative [[Radioactive iodine uptake|RAI therapy]]<br>Targeted therapy<br>[[External beam radiation therapy|EBRT]]<br>[[Chemotherapy]]}} | ||
* | {{familytree | | | | | | |,|-|-|^|-|-|.| | }} | ||
{{familytree | | | | | | D01 | | | | D03 | |D01=Iodine sensitive|D03=Iodine resistent}} | |||
{{familytree | | | | | | |!| | | | | |!| | |}} | |||
{{familytree | | | | | | E01 | | | | E02 | |E01=[[Radioactive iodine uptake|RAI therapy]]<br>Thyroid suppression therapy|E02=Thyroid suppression therapy<br>Targeted therapy<br>Surgery<br>[[External beam radiation therapy|EBRT]]}} | |||
{| | |||
! colspan="2" style="background:#DCDCDC;" align="center" + |'''Papillary Thyroid Cancer Treatment Options''' | |||
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|} | |||
* Pharmacologic medical therapies for papillary thyroid cancer include thyroid-suppression therapy, and/or targeted therapy. | |||
===Thyroid-suppression therapy=== | |||
* [[TSH]] suppression with [[thyroxine]] is effective in many [[lesions]] that are not sensitive to 131I. | |||
===Targeted therapy=== | |||
* This type of treatment is done using:<ref name="pmid23185034">{{cite journal |vauthors=Carhill AA, Cabanillas ME, Jimenez C, Waguespack SG, Habra MA, Hu M, Ying A, Vassilopoulou-Sellin R, Gagel RF, Sherman SI, Busaidy NL |title=The noninvestigational use of tyrosine kinase inhibitors in thyroid cancer: establishing a standard for patient safety and monitoring |journal=J. Clin. Endocrinol. Metab. |volume=98 |issue=1 |pages=31–42 |date=January 2013 |pmid=23185034 |pmc=3537108 |doi=10.1210/jc.2012-2909 |url=}}</ref><ref name="pmid22007339">{{cite journal |vauthors=Cabanillas ME, Hu MI, Durand JB, Busaidy NL |title=Challenges associated with tyrosine kinase inhibitor therapy for metastatic thyroid cancer |journal=J Thyroid Res |volume=2011 |issue= |pages=985780 |date=2011 |pmid=22007339 |pmc=3189619 |doi=10.4061/2011/985780 |url=}}</ref> | |||
** [[Sorafenib]], an Sorafenib is an orally active, multityrosine kinase inhibitor. | |||
** [[Lenvatinib]], an orally active, multitargeted tyrosine kinase inhibitor.<ref name="pmid25671254">{{cite journal |vauthors=Schlumberger M, Tahara M, Wirth LJ, Robinson B, Brose MS, Elisei R, Habra MA, Newbold K, Shah MH, Hoff AO, Gianoukakis AG, Kiyota N, Taylor MH, Kim SB, Krzyzanowska MK, Dutcus CE, de las Heras B, Zhu J, Sherman SI |title=Lenvatinib versus placebo in radioiodine-refractory thyroid cancer |journal=N. Engl. J. Med. |volume=372 |issue=7 |pages=621–30 |date=February 2015 |pmid=25671254 |doi=10.1056/NEJMoa1406470 |url=}}</ref> | |||
***'''Adult''' | |||
**** Preferred regimen: [[Lenvatinib]] 24 mg PO daily until disease progression or unacceptable [[toxicity]]. | |||
**** Alternative regimen: [[Sorefenib]] 400 mg PO q12h until disease progression or unacceptable [[toxicity]]. | |||
**** Alternative regimen: [[Larotrectinib]] 100 mg PO q12h until disease progression or unacceptable [[toxicity]]. | |||
**** Alternative regimen: [[Entrectinib]] 600 mg PO daily until disease progression or unacceptable [[toxicity]]. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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{{WikiDoc Sources}} | |||
[[Category:Endocrine system]] | [[Category:Endocrine system]] | ||
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[[Category:Hereditary cancers]] | [[Category:Hereditary cancers]] | ||
[[Category:Thyroid disease]] | [[Category:Thyroid disease]] | ||
Latest revision as of 23:34, 29 July 2020
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Papillary thyroid cancer Microchapters |
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Differentiating Papillary thyroid cancer from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Papillary thyroid cancer medical therapy On the Web |
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American Roentgen Ray Society Images of Papillary thyroid cancer medical therapy |
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Risk calculators and risk factors for Papillary thyroid cancer medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Ammu Susheela, M.D. [3]
Overview
Treatment options for papillary thyroid cancer differes according to the stage and invasion of the tumor and include surgery, external beam radiation therapy ( EBRT), Thyroid suppression therapy, and targeted therapy.
Medical Therapy
- Treatment options for papillary thyroid cancer include:[1]
| Papillary thyroid cnacer treatment | |||||||||||||||||||||||||||||||||||||
| Localized or regional tumor | Metastatic | Recurrent | |||||||||||||||||||||||||||||||||||
| Surgery Total thyroidectomy Lobectomy RAI therapy Thyroid suppression therapy EBRT | Surgery ± postoperative RAI therapy Targeted therapy EBRT Chemotherapy | ||||||||||||||||||||||||||||||||||||
| Iodine sensitive | Iodine resistent | ||||||||||||||||||||||||||||||||||||
| RAI therapy Thyroid suppression therapy | Thyroid suppression therapy Targeted therapy Surgery EBRT | ||||||||||||||||||||||||||||||||||||
| Papillary Thyroid Cancer Treatment Options |
|---|
- Pharmacologic medical therapies for papillary thyroid cancer include thyroid-suppression therapy, and/or targeted therapy.
Thyroid-suppression therapy
Targeted therapy
- This type of treatment is done using:[2][3]
- Sorafenib, an Sorafenib is an orally active, multityrosine kinase inhibitor.
- Lenvatinib, an orally active, multitargeted tyrosine kinase inhibitor.[4]
- Adult
- Preferred regimen: Lenvatinib 24 mg PO daily until disease progression or unacceptable toxicity.
- Alternative regimen: Sorefenib 400 mg PO q12h until disease progression or unacceptable toxicity.
- Alternative regimen: Larotrectinib 100 mg PO q12h until disease progression or unacceptable toxicity.
- Alternative regimen: Entrectinib 600 mg PO daily until disease progression or unacceptable toxicity.
- Adult
References
- ↑ "Thyroid Cancer Treatment (Adult) (PDQ®)–Health Professional Version - National Cancer Institute".
- ↑ Carhill AA, Cabanillas ME, Jimenez C, Waguespack SG, Habra MA, Hu M, Ying A, Vassilopoulou-Sellin R, Gagel RF, Sherman SI, Busaidy NL (January 2013). "The noninvestigational use of tyrosine kinase inhibitors in thyroid cancer: establishing a standard for patient safety and monitoring". J. Clin. Endocrinol. Metab. 98 (1): 31–42. doi:10.1210/jc.2012-2909. PMC 3537108. PMID 23185034.
- ↑ Cabanillas ME, Hu MI, Durand JB, Busaidy NL (2011). "Challenges associated with tyrosine kinase inhibitor therapy for metastatic thyroid cancer". J Thyroid Res. 2011: 985780. doi:10.4061/2011/985780. PMC 3189619. PMID 22007339.
- ↑ Schlumberger M, Tahara M, Wirth LJ, Robinson B, Brose MS, Elisei R, Habra MA, Newbold K, Shah MH, Hoff AO, Gianoukakis AG, Kiyota N, Taylor MH, Kim SB, Krzyzanowska MK, Dutcus CE, de las Heras B, Zhu J, Sherman SI (February 2015). "Lenvatinib versus placebo in radioiodine-refractory thyroid cancer". N. Engl. J. Med. 372 (7): 621–30. doi:10.1056/NEJMoa1406470. PMID 25671254.