PDF(Pubmed)
Abstract：
Although most follicular-derived thyroid cancers are well differentiated and have an overall excellent prognosis following treatment with surgery and radioiodine, management of advanced thyroid cancers, including iodine refractory disease and poorly differentiated/undifferentiated subtypes, is more challenging. Over the past decade, better understanding of the genetic drivers and immune milieu of advanced thyroid cancers has led to significant progress in the management of these patients. Numerous targeted kinase inhibitors are now approved by the U.S Food and Drug administration (FDA) for the treatment of advanced, radioiodine refractory differentiated thyroid cancers (DTC) as well as anaplastic thyroid cancer (ATC). Immunotherapy has also been thoroughly studied and has shown promise in selected cases. In this review, we summarize the progress in the understanding of the genetic landscape and the cellular and molecular basis of radioiodine refractory-DTC and ATC, as well as discuss the current treatment options and future therapeutic avenues.
摘要：
尽管大多数滤泡源性甲状腺癌分化良好，并且在手术和放射性碘治疗后总体预后良好，晚期甲状腺癌的管理，包括碘难治性疾病和低分化/未分化亚型，更具挑战性。在过去的十年里，对晚期甲状腺癌的遗传驱动因素和免疫环境的更好理解导致了这些患者的治疗取得重大进展.许多靶向激酶抑制剂现在被美国食品和药物管理局（FDA）批准用于治疗晚期，放射性碘难治性分化型甲状腺癌（DTC）以及间变性甲状腺癌（ATC）。免疫疗法也得到了彻底的研究，并在选定的病例中显示出希望。在这次审查中,我们总结了对放射性碘难治性DTC和ATC的遗传景观以及细胞和分子基础的理解进展，以及讨论当前的治疗选择和未来的治疗途径。
