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Oncology Briefings Vol. 6, No. 9

Release Date: December 18, 2008
Expiration Date: December 18, 2009

Publication Overview

Authors

Medical writer: Aarati Ranganathan, PhD; Reviewed by: Roger Cohen, MD

Overview and Purpose

Initial management of the well-differentiated and curable types of thyroid cancer involves a multimodality approach, including surgery and radiation therapy with iodine-131 (131I). However, effective therapeutic options are lacking for radioiodine-refractory or -resistant advanced disease and the aggressive types of thyroid cancers that do not respond to 131I. Numerous cytotoxic regimens have failed to demonstrate significant clinical benefit. Recently, the pivotal roles of tyrosine kinases (TKs) such as Ret, B-Raf, vascular endothelial growth factor (VEGF) receptor, and epidermal growth factor receptor (EGFR) in the tumorigenesis of thyroid cancer have been identified. Chromosomal rearrangements in the RET proto-oncogene leading to formation of the RET/papillary thyroid carcinoma (PTC) oncogene or activation of the RET proto-oncogene through germline point mutations occur in 20%-100% of papillary and medullary thyroid cancers. Expression of VEGF and mutations in BRAF are correlated with poor prognosis in PTC. In preclinical thyroid cancer models, agents targeting the Ret/B-Raf, VEGF, and EGFR pathways have demonstrated significant antitumor effects. In patients with advanced thyroid cancers, inhibition of these key signaling molecules with novel multitargeted and anti-EGFR TK inhibitors (TKIs) holds therapeutic potential.

The purpose of this activity is to summarize the rationale for investigating and recent clinical data on multitargeted TKIs in advanced thyroid cancer.

Target Audience

This activity is intended for medical oncologists involved in the care of patients with thyroid cancer. No specific skills or knowledge other than a basic training in oncology is required for successful participation in this activity.

Learning Objectives

Upon completion of this educational activity, you should be able to:

  • Discuss the rationale for targeting angiogenesis and the growth factor signaling pathways in thyroid cancer
  • Compare the efficacies of novel multitargeted and anti-EGFR TKIs in advanced thyroid cancer
  • Assess the safety and tolerability of multitargeted TKIs in early-phase trials of advanced thyroid cancer

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Aarati Ranganathan, PhD
No relevant relationships to disclose

Roger Cohen, MD
Research Funding – AstraZeneca, Bayer Pharmaceuticals Corporation, Novartis Pharmaceuticals Corporation, Pfizer Inc.
Speaker’s Bureau – Bristol-Myers Squibb Company/ImClone Systems Incorporated

PER Editorial Staff
No relevant relationships to disclose

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Commercial Support
An educational grant for this activity was provided by Bayer HealthCare Pharmaceuticals/Onyx Pharmaceuticals, Inc.

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Editor, Oncology Briefings
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Educational Grants

An educational grant for this activity was provided by:


  1. Bayer HealthCare Pharmaceuticals/
    Onyx Pharmaceuticals, Inc.