[Current progress and management in molecular targeted therapy for advanced thyroid cancer].

Surgery results in improved outcomes for most patients with thyroid cancer, but there are no effective treatment options for patients with locally advanced/metastatic medullary thyroid cancer(MTC), differentiated thyroid cancer(DTC)refractory to radioiodine therapy, or highly malignant anaplastic thyroid cancer(ATC). Recent studies have shown that tumorigenesis and dedifferentiation of thyroid cancer cells are caused by the activation of several major signaling pathways and the related molecular aberrations, as well as by angiogenesis mediated by the vascular endothelial growth factor receptor(VEGFR)and epidermal growth factor receptor(EGFR). The efficacy of using molecular targeted agents for thyroid cancer treatment is under investigation in Western countries. In April 2011, the Food and Drug Administration(FDA)approved the use of vandetanib for the treatment of advanced MTC based on the results of phase III clinical trials. At the 2013 American Society of Clinical Oncology(ASCO)meetings, investigators reported that sorafenib improved progression-free survival in patients with advanced DTC, according to a phase III trial. FDA approved the use of sorafenib for the treatment of advanced DTC in November 2013. A multicenter clinical trial for ATC is also currently underway. Further research is required in order to characterize the mechanisms of the therapeutic response, to delineate the optimal management of drug-related adverse effects, and to identify biomarkers that can predict the efficacy of therapy. A clinical trial of these novel molecular agents has just begun in Japan, but in the near future, this new treatment strategy could become standard treatment for patients with advanced thyroid cancer.