晚期甲状腺癌治疗的曙光——靶向和免疫治疗

Dawn of Advanced Thyroid Cancer Therapy:Targeted Therapy and Immunotherapy

近年来,甲状腺癌的发病率显著增加,大多数病例以分化型甲状腺癌为主,其特点是预后良好。然而,在初始治疗后仍有15%的患者出现疾病持续或复发,并且局部晚期或转移性癌症患者对既定治疗无效,最终有死亡的风险。国内外对于晚期甲状腺癌的治疗仍有争议,但都倾向于靶向和免疫治疗为主的综合治疗。随着对甲状腺癌分子发病机制的深入理解,临床上已批准了多种新的靶向治疗方法用于晚期甲状腺癌。中国临床肿瘤学会(CSCO)2021年指南和欧洲肿瘤内科学会(ESMO)2022年指南(更新)均将靶向治疗作为晚期甲状腺癌治疗的Ⅰ级推荐。本文将对晚期甲状腺癌临床治疗新进展作一综述。

In recent years,the incidence of thyroid cancer has increased significantly.Most of the cases are differentiated thyroid cancer,which is characterized by a good prognosis.However,15%of patients still have persistent or recurrent disease after initial treatment,and those with locally advanced or metastatic cancer are not cured with established treatments and at risk of death.The treatment of advanced thyroid cancer is still controversial at home and abroad,but it tends to targeted therapy and immunotherapy.With the in-depth understanding of the molecular pathogenesis of thyroid cancer,a variety of new targeted therapies have been approved for advanced thyroid cancer.The 2021 guidelines of the Chinese Society of Clinical Oncology(CSCO)and the 2022 guidelines of the European Society of Oncology(ESMO)regard targeted therapy as a level I recommendation for the treatment of advanced thyroid cancer.This article reviews the new progress in clinical treatment of advanced thyroid carcinoma.