Abstract：
Recently, selpercatinib, a highly selective inhibitor of RET receptor tyrosine kinase, has been used for RET-altered thyroid cancer. We present four cases of patients with advanced thyroid cancer who were treated with selpercatinib. The first patient was a 63-year-old male with advanced medullary thyroid cancer (MTC) treated with vandetanib. Six months ago, he had an intracranial hemorrhage and swallowing difficulty. He started selpercatinib with percutaneous endoscopic gastrostomy (PEG). For 11 months, a partial response (PR) was observed stably with PEG administration without any more cardiovascular events. The second patient was a 67-year-old female with advanced MTC treated with vandetatib. After selpercatinib treatment, a PR was observed for most metastatic sites, including choroidal metastasis. The third patient was a 32-year-old female with advanced papillary thyroid cancer (PTC) without history of systematic treatment. For six months, a PR was observed at her metastatic site with manageable adverse events. The last patient was a 59-year-old female with advanced PTC treated with lenvatinib. She suffered from a panic disorder and pleural pain due to metastasis during lenvatinib treatment. After selpercatinib treatment, her pain and panic symptoms were improved. Facing varying clinical obstacles of the real world, selpercatinib safely proved remarkable therapeutic efficacy regardless of previous treatment or metastatic site.
摘要：
最近,selpercatinib,RET受体酪氨酸激酶的高选择性抑制剂，已用于RET改变的甲状腺癌。我们介绍了4例接受selpercatinib治疗的晚期甲状腺癌患者。第一位患者是一名63岁的男性，患有晚期甲状腺髓样癌（MTC），接受vandetanib治疗。六个月前,他有颅内出血和吞咽困难。他开始使用经皮内镜胃造瘘术（PEG）进行selpercatinib。11个月来,PEG给药稳定观察到部分缓解(PR),无更多心血管事件.第二名患者是一名67岁的女性，患有vandetatib治疗的晚期MTC。selpercatinib治疗后，在大多数转移部位观察到PR，包括脉络膜转移.第三名患者是一名32岁的女性，患有晚期甲状腺乳头状癌（PTC），没有系统治疗史。六个月来,在她的转移部位观察到PR,并出现可控的不良事件.最后一名患者是一名59岁女性，患有晚期PTC，接受lenvatinib治疗。在lenvatinib治疗期间，由于转移，她患有恐慌症和胸膜疼痛。selpercatinib治疗后，她的疼痛和恐慌症状得到改善。面对现实世界的各种临床障碍，无论以前的治疗或转移部位如何，selpercatinib都安全地证明了显着的治疗效果。
