Recombinant human thyrotropin

Abstract

Initial management of patients with thyroid cancer generally includes surgical thyroidectomy, eradication of iodineavid tissue (benign or malignant) with radioactive iodine, and long-term treatment with L-thyroxine at doses sufficient for suppression of pituitary production of thyrotropin (TSH; 1,2). Thyroid cancer recurs in 20-40% of patients, requiring long-term monitoring for tumor recurrence or progression (3). Similar to most other malignancies, monitoring is done by physical examination, measurement of tissue or tumor-specific serum markers, and radiographic and sonographic imaging. Measurements of serum thyroglobulin concentrations and radioiodine whole-body imaging are used most frequently to monitor thyroid cancer patients (1,4). Both of these modalities measure relatively thyroid-specific functions. However, the sensitivities of iodine scanning and thyroglobulin measurement are limited by the small, relative amount of thyroid tissue present in patients treated by thyroidectomy and dedifferentiation of tumor cells compared to normal thyrocytes. Therefore, for optimal sensitivity, both radioiodine imaging and serum thyroglobulin measurement require stimulation of thyroid tissue by elevated TSH levels. Moreover, elevated serum concentrations of TSH are also required for radioiodine therapy. © 2006 Humana Press Inc.