Медицинская литература. Новинки

 

 

 

 

 

 

Роль таргетной терапии мультикиназными ингибиторами в лечении резистентного к радиойодтерапии дифференцированного рака щитовидной железы

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У 5-15% больных дифференцированным раком щитовидной железы (ДРЩЖ) изначально или в процессе лечения развиваются метастазы, резистентные к терапии радиоактивным йодом, что драматически ухудшает прогноз выживаемости. Другие способы лечения (лучевая терапия, химиотерапия и пр.) также неэффективны. Определенные надежды возлагаются на таргетную терапию мультикиназными ингибиторами, которые селективно блокируют различные онкокиназные молекулярные мишени. В обзоре представлен анализ препаратов этой группы, изучавшихся при радиойодрезистентном ДРЩЖ. Проведен сравнительный анализ эффективности и профиля токсичности двух наиболее перспективных мультикиназных ингибиторов (сорафениб, ленватиниб), успешно прошедших третью фазу клинических исследований и рекомендованных в качестве терапии выбора больным прогрессирующим радиойодрезистентным ДРЩЖ.

Ключевые слова:
дифференцированный рак щитовидной железы, радиойодрезистентность, таргетная терапия, мультикиназные ингибиторы, сорафениб, ленватиниб, well-differentiated thyroid cancer, radioiodine resistance, target therapy, multikinase inhibitors, sorafenib, lenvatinib

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The role of multikinase inhibitors target therapy in radioiodine-resistant differentiated thyroid cancer

About 5-15% of patients with differentiated thyroid cancer (DTC) primary or within follow-up have had distant metastases or inoperable tumor mass that are resistant to radioiodine therapy as well as dramatically deteriorate survival prognosis. Other treatment modalities (radiotherapy, chemotherapy etc.) also ineffective. Certain expectances are associated with target therapy with multikinase inhibitors with are selectively blocking onco-kinase molecular pathways. This review is devoted to analysis of those multikinase inhibitors which have been implemented in patients with radioiodine DTC. Comparative analysis of two most perspective multikinase inhibitors (sorafenib and lenvatinib) with evaluation of efficacy and adverse effects was conducted. Both of them successfully underwent 3 rd phase of clinical trial and were recommended as treatment of choice in progressive radioiodine-resistant DTC patients.

Keywords:
дифференцированный рак щитовидной железы, радиойодрезистентность, таргетная терапия, мультикиназные ингибиторы, сорафениб, ленватиниб, well-differentiated thyroid cancer, radioiodine resistance, target therapy, multikinase inhibitors, sorafenib, lenvatinib