Perspectives on the use of tyrosine kinase inhibitors in thyroid cancer

Abstract

Introduction: Thyroid cancer has generally a good prognosis after surgical and/or radioactive iodine (RAI) treatment; however, these tumors that persist or that are not candidate to these treatments have a worse prognosis, which makes the use of tyrosine kinase inhibitors (TKIs) a good management alternative, since it has demonstrated progression-free survival (PFS) and response rate benefits, and it is, therefore, important to describe new markers and future therapies for this type of tumors. Materials and methods: The purpose of this review is to describe the current state of the treatment of advanced or relapsing thyroid cancer that is not susceptible to management with surgery or RAI, the benefits, and limitations of the use of TKIs, as well as an analysis of this tumor’s molecular biology and its clinical repercussion. Results: The use of sorafenib and lenvatinib in differentiated thyroid carcinoma that is refractory to RAI, and cabozantinib and vandetanib for advanced medullary carcinomas, has demonstrated benefit in this type of patients, with an impact on PFS, response rates, and disease control. There are ongoing studies with immunotherapy, and we will be alert for their results. Conclusion: The treatment with TKI in metastatic thyroid cancer, has shown benefit, the determination of mutations and markers will determine which is the best TKI for the different subtypes of thyroid cancer.