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Moving towards the use of targeted therapies in thyroid cancer

Nature Clinical Practice Endocrinology & Metabolism volume 4, pages 604–605 (2008)Cite this article

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Thyroid cancer might be perceived as relatively rare, but it is in fact more common than ovarian, bladder or pancreatic cancer.1,2,3 Unlike most other tumor types, however, treatment of thyroid cancer has not changed substantially for several decades. Total thyroidectomy and administration of ablative radioiodine remain the cornerstones of the therapeutic regimen, which is associated with a good 5-year survival rate. Nonetheless, thyroid cancer treatment is not perfect, and several hurdles remain to be overcome. Although many of the molecular pathways associated with the pathogenesis of differentiated thyroid cancer have been elucidated (particularly for papillary cancers), tumor formation is associated with many genetic and environmental causes. In addition to multiple initiating events, numerous factors are also required to promote thyroid cancer progression.4 Furthermore, thyroid cancers can be well differentiated, poorly differentiated or anaplastic. These histotypes are associated with strikingly contrasting consequences and implications. In light of such etiologic diversity, the current challenge is to increase the efficacy of thyroid cancer treatment by addressing individuality of tumor type. In this Viewpoint, I discuss how we might move towards the introduction of novel targeted therapies into routine clinical practice.

Differentiated thyroid cancer is relatively accessible, has simple treatment options, and even expresses a sodium–iodide symporter that can be exploited for targeted treatment and ablation. Arguably, these factors have contributed to a more static rate of treatment development than has occurred for other tumor types. For example, if breast cancer were more like thyroid cancer, would we now have drugs such as tamoxifen or anastrozole? Or would there be insufficient drive to develop de novo hormonal or chemotherapeutic agents? In other words, has the relative ease of thyroid cancer treatment reduced the desire for more-sophisticated therapies? In particular, few effective therapies exist for those thyroid cancers that do not take up iodide, that are invasive or metastatic, or that are not surgically resectable. Clearly, there is a need for enhanced strategies to complement the existing options in such cases.

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  1. Division of Medical Sciences, Institute of Biomedical Research, University of Birmingham, Birmingham B15 2TH, UK c.j.mccabe.med@bham.ac.uk

Authors and Affiliations

  1. CJ McCabe is a Reader in Endocrine Cancer in the Division of Medical Sciences at the University of Birmingham, UK.,

    Christopher J McCabe

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McCabe, C. Moving towards the use of targeted therapies in thyroid cancer. Nat Rev Endocrinol 4, 604–605 (2008). https://doi.org/10.1038/ncpendmet0944

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