TY - JOUR
T1 - Medullary thyroid carcinoma
AU - Jaber, Tania
AU - Dadu, Ramona
AU - Hu, Mimi I.
N1 - Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Purpose of reviewTo summarize recent developments in the diagnosis and management of patients with medullary thyroid cancer (MTC), with a focus on pathogenesis, systemic therapy, and future directions.Recent findingsThe addition of mutational analysis to cytological assessment of thyroid nodules has improved the diagnostic accuracy of MTC. The discovery of new genomic alterations and overexpression of certain factors allows for improved prognostication in MTC and provides potentially new therapeutic agents. New data suggest that tumor environment may be more immunogenic than previously thought in a subset of MTCs with identification of a new MTC-specific antigen leading to a revival of investigating immune-based therapy for this disease. The newly approved selective rearranged during transfection (RET0-inhibitors, selpercatinib and pralsetinib, offer promising results, and tolerability for patients with RET-mutated MTC; however, the development of resistance mechanisms may be problematic.SummaryMTC has witnessed remarkable advancements in recent years. Our new understanding of some of the driver mutations in MTC allows for therapeutics with more tolerable adverse event profiles. However, there is still a need for more effective treatment strategies for subsets of patients without actionable mutations and for those who develop resistance to currently available therapies.
AB - Purpose of reviewTo summarize recent developments in the diagnosis and management of patients with medullary thyroid cancer (MTC), with a focus on pathogenesis, systemic therapy, and future directions.Recent findingsThe addition of mutational analysis to cytological assessment of thyroid nodules has improved the diagnostic accuracy of MTC. The discovery of new genomic alterations and overexpression of certain factors allows for improved prognostication in MTC and provides potentially new therapeutic agents. New data suggest that tumor environment may be more immunogenic than previously thought in a subset of MTCs with identification of a new MTC-specific antigen leading to a revival of investigating immune-based therapy for this disease. The newly approved selective rearranged during transfection (RET0-inhibitors, selpercatinib and pralsetinib, offer promising results, and tolerability for patients with RET-mutated MTC; however, the development of resistance mechanisms may be problematic.SummaryMTC has witnessed remarkable advancements in recent years. Our new understanding of some of the driver mutations in MTC allows for therapeutics with more tolerable adverse event profiles. However, there is still a need for more effective treatment strategies for subsets of patients without actionable mutations and for those who develop resistance to currently available therapies.
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U2 - 10.1097/MED.0000000000000662
DO - 10.1097/MED.0000000000000662
M3 - Review article
C2 - 34292174
AN - SCOPUS:85115449217
SN - 1752-296X
VL - 28
SP - 540
EP - 546
JO - Current Opinion in Endocrinology, Diabetes and Obesity
JF - Current Opinion in Endocrinology, Diabetes and Obesity
IS - 5
ER -