Kinase-inhibitors for iodine-refractory differentiated thyroid cancer: still far from a structured therapeutic algorithm

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Abstract

The kinase-inhibitors (KIs) sorafenib and lenvatinib demonstrated efficacy in iodine-refractory DTC upon phase III studies. However, evidence allowing a punctual balance of benefits and risks is poor. Furthermore, the lack of a direct comparison hampers to establish the proper sequence of administration. However, some insights may provided: a) indirect comparison between phase III trials showed milder toxicity for sorafenib, which should be preferred in case of cardiovascular comorbidities; b) prospective evidence of efficacy in KIs pre-treated patients is available only for lenvatinib, which should be used as second-line. Promising activity was found for the majority of other tested KIs, but no placebo-controlled trials are available. Emerging, but still early, frontiers include the restoration of iodine-sensitivity and the selective activity on pathogenic mutations. In conclusion, the use of KIs in iodine-refractory DTC is far from a structured therapeutic algorithm.

Original languageEnglish
Article number103353
JournalCritical Reviews in Oncology/Hematology
Volume162
DOIs
Publication statusPublished - Jun 2021

Keywords

  • Iodine-refractory
  • Kinase-inhibitors
  • Targeted therapies
  • Thyroid cancer
  • Thyroid diseases
  • Thyroid nodules

ASJC Scopus subject areas

  • Hematology
  • Oncology

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