甲状腺髓样癌靶向治疗

Targeted therapy of medullary thyroid carcinoma

甲状腺髓样癌侵袭性强,易发生淋巴结转移和远处转移,预后欠佳。其发病常表现为RET基因突变,M918T在所有突变中预后最差,提示临床上应早期重视甲状腺髓样癌的基因检测。对于晚期、进展性、无法切除的甲状腺髓样癌,靶向治疗占绝对主导地位。靶向药物的介入时间仍然是值得探讨的课题。随着凡德他尼、卡博替尼、安罗替尼、BLU-667、LOXO-292等靶向药物的不断涌现,在关注药物疗效的同时,需要把握毒副反应及病人生活质量之间的平衡。

Medullary thyroid carcinoma is highly aggressive,prone to lymph node metastasis and distant metastasis,and the prognosis is poor.Its incidence is often manifested as RET gene mutations.M918T has the worst prognosis among all mutations,suggesting that early clinical attention should be paid to genetic testing of medullary thyroid cancer.For advanced,progressive,and unresectable medullary thyroid cancer,targeted therapy is absolutely dominant.The intervention time of targeted drugs is still a topic worthy of discussion.With the continuous emergence of targeted drugs such as vandetanib,cabozantinib,anlotinib,BLU-667,LOXO-292,while paying attention to the efficacy of drugs,it is necessary to grasp the relationship between side effects and the quality of life of patients.