Nicht-medulläre Schilddrüsenkarzinome – Neue Strategien und aktuelle medikamentöse Therapiekonzepte

Die therapeutischen Optionen für fortgeschrittene papilläre, follikuläre und anaplastische Schilddrüsenkarzinome sind beschränkt, die Evaluierung neuer Strategien ist Gegenstand der aktuellen klinischen Forschung. Zu den Therapieprinzipien gehören die Inhibition der Zellproliferation und der Tumorangiogenese sowie die Induktion einer Redifferenzierung maligner Zellen. Kurative Therapieansätze gibt es aktuell jedoch nicht. Kinaseinhibitoren, die sowohl Zellwachstum als auch Angiogenese beeinflussen, sind nach aktueller Datenlage die vielversprechendsten Substanzen, um das Überleben der Patienten zu verlängern. Patienten, die an einer dieser 3 Schilddrüsenkarzinomentitäten leiden, sollten nach Möglichkeit in klinische Studien eingeschlossen werden. Für Patienten die nicht in klinische Studien eingeschlossen werden können, ist Sorafenib in den meisten Behandlungszentren die Therapie der ersten Wahl. Darüber hinaus werden sequenzielle Therapien mit unterschiedlichen Substanzen eine wichtige Rolle spielen, um das Überleben und die Lebensqualität der Patienten zu verbessern.

Therapeutic options for advanced papillary, follicular, and anaplastic thyroid carcinomas are limited. Novel therapeutic strategies are currently under investigation in clinical studies. Among the therapeutic principles of these strategies are the inhibitions of proliferation and angiogenesis, as well as the induction of re-differentiation of malignant cells. Curative therapeutic strategies are not available to date. According to current data, kinase inhibitors which modulate cell proliferation and angiogenesis are the most promising drugs to prolong survival. Patients suffering from one of these three thyroid carcinomas should participate in clinical trials. In most cancer centers, sorafenib is the substance of first choice to treat patients not recruited for clinical trials. Sequential therapeutic steps with different drugs will play an important role in prolonging patient survival and improving quality of life.

Key words

Non-medullary thyroid cancer - multikinase inhibitors - angiogenesis inhibitors - re-differentiation therapies

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