Difference between revisions of "Staging page"
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[[#top|Back to Top]] | [[#top|Back to Top]] | ||
</div> | </div> | ||
− | + | {{#lst:Section editor transclusions|endo}} | |
+ | <div class="noprint" style="background-color:LightGray; position:fixed; bottom:2%; right:0.25%; padding-left:5px; padding-right:5px; margin: 15px; opacity:0.8; border-style: solid; border-color:DarkGray; border-width: 1px"> | ||
+ | [[#top|Back to Top]] | ||
+ | </div> | ||
+ | Note: these are regimens tested in histology-specific populations, please see the '''[[Thyroid cancer|main thyroid cancer page]]''' for other regimens. | ||
{| class="wikitable" style="float:right; margin-right: 5px;" | {| class="wikitable" style="float:right; margin-right: 5px;" | ||
|- | |- | ||
− | |<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] | + | |<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div> |
− | <div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] | + | <div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div> |
− | |} | + | |} |
{{TOC limit|limit=3}} | {{TOC limit|limit=3}} | ||
− | = | + | =Guidelines= |
− | == | + | ==[https://www.thyroid.org/ ATA]== |
− | + | *'''2015:''' Guidelines for the management of medullary thyroid carcinoma [https://pubmed.ncbi.nlm.nih.gov/27118126 PubMed] | |
+ | ==[http://www.esmo.org/ ESMO]== | ||
+ | *'''2019:''' Filetti et al. [https://doi.org/10.1093/annonc/mdz400 Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up] | ||
+ | ===Older=== | ||
+ | *'''2012:''' Pacini et al. [http://annonc.oxfordjournals.org/content/23/suppl_7/vii110.full.pdf+html Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up] [https://pubmed.ncbi.nlm.nih.gov/22997443 PubMed] | ||
+ | ==[https://www.nccn.org/ NCCN]== | ||
+ | *[https://www.nccn.org/professionals/physician_gls/pdf/thyroid.pdf NCCN Guidelines - Thyroid Carcinoma] | ||
+ | =All lines of therapy= | ||
+ | ==Cabozantinib monotherapy {{#subobject:1d67e4|Regimen=1}}== | ||
<div class="toccolours" style="background-color:#eeeeee"> | <div class="toccolours" style="background-color:#eeeeee"> | ||
− | ===Regimen {{#subobject: | + | ===Regimen {{#subobject:d4c2dd|Variant=1}}=== |
{| class="wikitable sortable" style="width: 100%; text-align:center;" | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
!style="width: 20%"|Study | !style="width: 20%"|Study | ||
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!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | |[https:// | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3646303/ Kurzrock et al. 2011 (XL184-001)] |
− | + | |2005-2008 | |
− | + | | style="background-color:#91cf61" |Non-randomized | |
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− | | style="background-color:#91cf61" |Non-randomized | ||
| style="background-color:#d3d3d3" | | | style="background-color:#d3d3d3" | | ||
| style="background-color:#d3d3d3" | | | style="background-color:#d3d3d3" | | ||
|- | |- | ||
− | |[https:// | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164813/ Elisei et al. 2013 (EXAM)] |
− | | | + | |2008-2011 |
− | |style="background-color:#1a9851"|Phase 3 ( | + | | style="background-color:#1a9851" |Phase 3 (E-RT-esc) |
− | |[[# | + | |[[#Placebo_2|Placebo]] |
− | | style="background-color:# | + | | style="background-color:#1a9850" |Superior PFS<br>Median PFS: 11.2 vs 4 mo<br>(HR 0.28, 95% CI 0.19-0.40) |
|- | |- | ||
|} | |} | ||
+ | ''Note: To be taken at least 2 hours before or 1 hour after meals.'' | ||
<div class="toccolours" style="background-color:#b3e2cd"> | <div class="toccolours" style="background-color:#b3e2cd"> | ||
− | ==== | + | ====Targeted therapy==== |
− | + | *[[Cabozantinib (Cometriq)]] 140 mg PO once per day | |
− | + | '''Continued indefinitely''' | |
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</div></div> | </div></div> | ||
===References=== | ===References=== | ||
− | # ''' | + | # '''XL184-001:''' Kurzrock R, Sherman SI, Ball DW, Forastiere AA, Cohen RB, Mehra R, Pfister DG, Cohen EE, Janisch L, Nauling F, Hong DS, Ng CS, Ye L, Gagel RF, Frye J, Müller T, Ratain MJ, Salgia R. Activity of XL184 (Cabozantinib), an oral tyrosine kinase inhibitor, in patients with medullary thyroid cancer. J Clin Oncol. 2011 Jul 1;29(19):2660-6. Epub 2011 May 23. [https://doi.org/10.1200/jco.2010.32.4145 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3646303/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/21606412 PubMed] NCT00215605 |
− | = | + | # '''EXAM:''' Elisei R, Schlumberger MJ, Müller SP, Schöffski P, Brose MS, Shah MH, Licitra L, Jarzab B, Medvedev V, Kreissl MC, Niederle B, Cohen EE, Wirth LJ, Ali H, Hessel C, Yaron Y, Ball D, Nelkin B, Sherman SI. Cabozantinib in progressive medullary thyroid cancer. J Clin Oncol. 2013 Oct 10;31(29):3639-46. Epub 2013 Sep 3. Erratum in: J Clin Oncol. 2014 Jun 10;32(17):1864. [https://doi.org/10.1200/jco.2012.48.4659 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164813/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/24002501 PubMed] NCT00704730 |
− | + | ## '''Update:''' Schlumberger M, Elisei R, Müller S, Schöffski P, Brose M, Shah M, Licitra L, Krajewska J, Kreissl MC, Niederle B, Cohen EEW, Wirth L, Ali H, Clary DO, Yaron Y, Mangeshkar M, Ball D, Nelkin B, Sherman S. Overall survival analysis of EXAM, a phase III trial of cabozantinib in patients with radiographically progressive medullary thyroid carcinoma. Ann Oncol. 2017 Nov 1;28(11):2813-2819. [https://doi.org/10.1093/annonc/mdx479 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5834040/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/29045520 PubMed] | |
+ | ==Placebo== | ||
<div class="toccolours" style="background-color:#eeeeee"> | <div class="toccolours" style="background-color:#eeeeee"> | ||
===Regimen=== | ===Regimen=== | ||
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!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | |[https:// | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675689/ Wells et al. 2011 (ZETA)] |
− | + | |2006-2007 | |
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| style="background-color:#1a9851" |Phase 3 (C) | | style="background-color:#1a9851" |Phase 3 (C) | ||
− | | | + | |[[#Vandetanib_monotherapy_2|Vandetanib]] |
− | | style="background-color:# | + | | style="background-color:#d73027" |Inferior PFS |
|- | |- | ||
− | |[https:// | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164813/ Elisei et al. 2013 (EXAM)] |
− | | | + | |2008-2011 |
| style="background-color:#1a9851" |Phase 3 (C) | | style="background-color:#1a9851" |Phase 3 (C) | ||
− | | | + | |[[#Cabozantinib_monotherapy|Cabozantinib]] |
− | | style="background-color:# | + | | style="background-color:#d73027" |Inferior PFS |
|- | |- | ||
|} | |} | ||
− | + | ''No active antineoplastic treatment. Included for reference purposes only.'' | |
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− | '' | ||
</div></div> | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | # '''ZETA:''' Wells SA Jr, Robinson BG, Gagel RF, Dralle H, Fagin JA, Santoro M, Baudin E, Elisei R, Jarzab B, Vasselli JR, Read J, Langmuir P, Ryan AJ, Schlumberger MJ. Vandetanib in patients with locally advanced or metastatic medullary thyroid cancer: a randomized, double-blind phase III trial. J Clin Oncol. 2012 Jan 10;30(2):134-41. Epub 2011 Oct 24. [https://doi.org/10.1200/jco.2011.35.5040 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675689/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/22025146 PubMed] NCT00410761 |
− | # ''' | + | # '''EXAM:''' Elisei R, Schlumberger MJ, Müller SP, Schöffski P, Brose MS, Shah MH, Licitra L, Jarzab B, Medvedev V, Kreissl MC, Niederle B, Cohen EE, Wirth LJ, Ali H, Hessel C, Yaron Y, Ball D, Nelkin B, Sherman SI. Cabozantinib in progressive medullary thyroid cancer. J Clin Oncol. 2013 Oct 10;31(29):3639-46. Epub 2013 Sep 3. Erratum in: J Clin Oncol. 2014 Jun 10;32(17):1864. [https://doi.org/10.1200/jco.2012.48.4659 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164813/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/24002501 PubMed] NCT00704730 |
− | == | + | ==Sorafenib monotherapy {{#subobject:7e7480|Regimen=1}}== |
− | |||
<div class="toccolours" style="background-color:#eeeeee"> | <div class="toccolours" style="background-color:#eeeeee"> | ||
− | ===Regimen {{#subobject: | + | ===Regimen {{#subobject:1e2f21|Variant=1}}=== |
− | {| class="wikitable sortable" style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
− | !style="width: | + | !style="width: 33%"|Years of enrollment |
− | !style="width: | + | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] |
− | |||
− | |||
|- | |- | ||
− | |[https:// | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2881718/ Lam et al. 2010 (OSU 06054)] |
− | | | + | |2006-2008 |
− | |style="background-color:# | + | | style="background-color:#91cf61" |Phase 2 |
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|- | |- | ||
|} | |} | ||
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<div class="toccolours" style="background-color:#b3e2cd"> | <div class="toccolours" style="background-color:#b3e2cd"> | ||
− | ==== | + | ====Targeted therapy==== |
− | *[[ | + | *[[Sorafenib (Nexavar)]] 400 mg PO twice per day |
− | + | '''Continued indefinitely''' | |
</div></div> | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | # '''OSU 06054:''' Lam ET, Ringel MD, Kloos RT, Prior TW, Knopp MV, Liang J, Sammet S, Hall NC, Wakely PE Jr, Vasko VV, Saji M, Snyder PJ, Wei L, Arbogast D, Collamore M, Wright JJ, Moley JF, Villalona-Calero MA, Shah MH. Phase II clinical trial of sorafenib in metastatic medullary thyroid cancer. J Clin Oncol. 2010 May 10;28(14):2323-30. Epub 2010 Apr 5. [https://doi.org/10.1200/jco.2009.25.0068 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2881718/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20368568 PubMed] NCT00390325 |
− | == | + | ==Sunitinib monotherapy {{#subobject:59fa83|Regimen=1}}== |
− | |||
<div class="toccolours" style="background-color:#eeeeee"> | <div class="toccolours" style="background-color:#eeeeee"> | ||
− | ===Regimen {{#subobject: | + | ===Regimen {{#subobject:7e9b73|Variant=1}}=== |
− | {| class="wikitable sortable" style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
− | !style="width: | + | !style="width: 33%"|Years of enrollment |
− | !style="width: | + | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] |
− | |||
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|- | |- | ||
− | |[https:// | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063514/ Carr et al. 2010] |
− | + | |2007-2009 | |
− | + | | style="background-color:#91cf61" |Phase 2 | |
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− | |style="background-color:# | ||
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|} | |} | ||
<div class="toccolours" style="background-color:#b3e2cd"> | <div class="toccolours" style="background-color:#b3e2cd"> | ||
− | ==== | + | ====Targeted therapy==== |
− | *[[ | + | *[[Sunitinib (Sutent)]] 37.5 mg PO once per day |
− | + | '''Continued indefinitely''' | |
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− | ''' | ||
</div></div> | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | # Carr LL, Mankoff DA, Goulart BH, Eaton KD, Capell PT, Kell EM, Bauman JE, Martins RG. Phase II study of daily sunitinib in FDG-PET-positive, iodine-refractory differentiated thyroid cancer and metastatic medullary carcinoma of the thyroid with functional imaging correlation. Clin Cancer Res. 2010 Nov 1;16(21):5260-8. Epub 2010 Sep 16. [https://doi.org/10.1158/1078-0432.CCR-10-0994 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063514/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20847059 PubMed] |
− | == | + | ==Vandetanib monotherapy {{#subobject:a85524|Regimen=1}}== |
− | |||
<div class="toccolours" style="background-color:#eeeeee"> | <div class="toccolours" style="background-color:#eeeeee"> | ||
− | ===Regimen | + | ===Regimen variant #1, 100 mg/day {{#subobject:148745|Variant=1}}=== |
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!style="width: 33%"|Study | !style="width: 33%"|Study | ||
!style="width: 33%"|Years of enrollment | !style="width: 33%"|Years of enrollment | ||
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
|- | |- | ||
− | |[https:// | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902067/ Robinson et al. 2010 (D4200C00068)] |
− | | | + | |2006-2007 |
− | | style="background-color:# | + | | style="background-color:#ffffbe" |Phase 2, <20 patients |
|- | |- | ||
|} | |} | ||
<div class="toccolours" style="background-color:#b3e2cd"> | <div class="toccolours" style="background-color:#b3e2cd"> | ||
− | ==== | + | ====Targeted therapy==== |
− | *[[ | + | *[[Vandetanib (Caprelsa)]] 100 mg PO once per day |
− | + | '''Continued indefinitely''' | |
− | + | </div> | |
− | </div>< | + | <div class="toccolours" style="background-color:#cbd5e7"> |
− | === | + | ====Subsequent treatment==== |
− | + | *At progression, eligible patients could increase the dose to 300 mg PO once per day; see paper for details | |
− | + | </div></div><br> | |
− | |||
<div class="toccolours" style="background-color:#eeeeee"> | <div class="toccolours" style="background-color:#eeeeee"> | ||
− | ===Regimen {{#subobject: | + | ===Regimen variant #2, 300 mg/day {{#subobject:e75f4f|Variant=1}}=== |
{| class="wikitable sortable" style="width: 100%; text-align:center;" | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
!style="width: 20%"|Study | !style="width: 20%"|Study | ||
Line 642: | Line 156: | ||
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | |[https:// | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2834392/ Wells et al. 2010] |
− | | | + | |2004-2006 |
− | | style="background-color:#91cf61" | | + | | style="background-color:#91cf61" |Phase 2 |
| style="background-color:#d3d3d3" | | | style="background-color:#d3d3d3" | | ||
| style="background-color:#d3d3d3" | | | style="background-color:#d3d3d3" | | ||
|- | |- | ||
− | |[https:// | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675689/ Wells et al. 2011 (ZETA)] |
− | | | + | |2006-2007 |
− | |style="background-color:#1a9851"|Phase 3 (E-esc) | + | | style="background-color:#1a9851" |Phase 3 (E-RT-esc) |
− | |[[# | + | |[[#Placebo_2|Placebo]] |
− | |style="background-color:#1a9850"|Superior | + | | style="background-color:#1a9850" |Superior PFS<br>Median PFS: NYR vs 19.3 mo<br>(HR 0.46, 95% CI 0.31-0.69) |
|- | |- | ||
|} | |} | ||
<div class="toccolours" style="background-color:#b3e2cd"> | <div class="toccolours" style="background-color:#b3e2cd"> | ||
− | ==== | + | ====Targeted therapy==== |
− | *[[ | + | *[[Vandetanib (Caprelsa)]] 300 mg PO once per day |
− | + | '''Continued indefinitely''' | |
− | |||
− | |||
</div></div> | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | # Wells SA Jr, Gosnell JE, Gagel RF, Moley J, Pfister D, Sosa JA, Skinner M, Krebs A, Vasselli J, Schlumberger M. Vandetanib for the treatment of patients with locally advanced or metastatic hereditary medullary thyroid cancer. J Clin Oncol. 2010 Feb 10;28(5):767-72. Epub 2010 Jan 11. [https://doi.org/10.1200/jco.2009.23.6604 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2834392/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20065189 PubMed] |
− | # | + | # '''D4200C00068:''' Robinson BG, Paz-Ares L, Krebs A, Vasselli J, Haddad R. Vandetanib (100 mg) in patients with locally advanced or metastatic hereditary medullary thyroid cancer. J Clin Endocrinol Metab. 2010 Jun;95(6):2664-71. Epub 2010 Apr 6. [https://doi.org/10.1210/jc.2009-2461 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902067/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20371662 PubMed] content property of [http://hemonc.org HemOnc.org] NCT00358956 |
− | == | + | # '''ZETA:''' Wells SA Jr, Robinson BG, Gagel RF, Dralle H, Fagin JA, Santoro M, Baudin E, Elisei R, Jarzab B, Vasselli JR, Read J, Langmuir P, Ryan AJ, Schlumberger MJ. Vandetanib in patients with locally advanced or metastatic medullary thyroid cancer: a randomized, double-blind phase III trial. J Clin Oncol. 2012 Jan 10;30(2):134-41. Epub 2011 Oct 24. [https://doi.org/10.1200/jco.2011.35.5040 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675689/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/22025146 PubMed] NCT00410761 |
− | + | =Advanced or metastatic disease= | |
− | + | ==Axitinib monotherapy {{#subobject:73fcb6|Regimen=1}}== | |
<div class="toccolours" style="background-color:#eeeeee"> | <div class="toccolours" style="background-color:#eeeeee"> | ||
− | ===Regimen {{#subobject: | + | ===Regimen {{#subobject:aff447|Variant=1}}=== |
− | {| class="wikitable sortable" style="width: | + | {| class="wikitable sortable" style="width: 60%; text-align:center;" |
− | !style="width: | + | !style="width: 33%"|Study |
− | !style="width: | + | !style="width: 33%"|Years of enrollment |
− | !style="width: | + | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] |
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|- | |- | ||
− | | | + | |[https://doi.org/10.1002/cncr.28766 Locati et al. 2014 (A4061027)] |
− | + | |2006-2008 | |
− | + | | style="background-color:#91cf61" |Phase 2 | |
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<div class="toccolours" style="background-color:#b3e2cd"> | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Targeted therapy==== | ====Targeted therapy==== | ||
− | *[[ | + | *[[Axitinib (Inlyta)]] 5 mg PO twice per day |
'''Continued indefinitely''' | '''Continued indefinitely''' | ||
</div></div> | </div></div> | ||
===References=== | ===References=== | ||
− | # ''' | + | # '''A4061027:''' Locati LD, Licitra L, Agate L, Ou SH, Boucher A, Jarzab B, Qin S, Kane MA, Wirth LJ, Chen C, Kim S, Ingrosso A, Pithavala YK, Bycott P, Cohen EE. Treatment of advanced thyroid cancer with axitinib: Phase 2 study with pharmacokinetic/pharmacodynamic and quality-of-life assessments. Cancer. 2014 Sep 1;120(17):2694-703. Epub 2014 May 20. [https://doi.org/10.1002/cncr.28766 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/24844950 PubMed] NCT00389441 |
− | + | ==Sunitinib monotherapy {{#subobject:8d6c5|Regimen=1}}== | |
− | |||
− | |||
− | == | ||
<div class="toccolours" style="background-color:#eeeeee"> | <div class="toccolours" style="background-color:#eeeeee"> | ||
− | ===Regimen {{#subobject: | + | ===Regimen {{#subobject:d1cea4|Variant=1}}=== |
− | {| class="wikitable sortable" style="width: | + | {| class="wikitable sortable" style="width: 80%; text-align:center;" |
− | !style="width: | + | !style="width: 25%"|Study |
− | !style="width: | + | !style="width: 25%"|Years of enrollment |
− | !style="width: | + | !style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]] |
− | !style="width: | + | !style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]] |
− | |||
|- | |- | ||
− | + | |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063514/ Carr et al. 2010] | |
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− | |[https://www.ncbi.nlm.nih.gov/pmc/articles/ | ||
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|2007-2009 | |2007-2009 | ||
− | |style="background-color:# | + | | style="background-color:#91cf61" |Phase 2 |
− | + | |ORR: 31% (95% CI: 16-47) | |
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<div class="toccolours" style="background-color:#b3e2cd"> | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Targeted therapy==== | ====Targeted therapy==== | ||
− | *[[ | + | *[[Sunitinib (Sutent)]] 37.5 mg PO once per day |
'''Continued indefinitely''' | '''Continued indefinitely''' | ||
</div></div> | </div></div> | ||
===References=== | ===References=== | ||
− | # | + | # Carr LL, Mankoff DA, Goulart BH, Eaton KD, Capell PT, Kell EM, Bauman JE, Martins RG. Phase II study of daily sunitinib in FDG-PET-positive, iodine-refractory differentiated thyroid cancer and metastatic medullary carcinoma of the thyroid with functional imaging correlation. Clin Cancer Res. 2010 Nov 1;16(21):5260-8. Epub 2010 Sep 16. [https://doi.org/10.1158/1078-0432.CCR-10-0994 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063514/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20847059 PubMed] |
− | + | [[Category:Thyroid cancer regimens]] | |
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− | [[Category: | ||
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[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
− | [[Category: | + | [[Category:Endocrine cancers]] |
+ | [[Category:Head and neck cancers]] |
Revision as of 23:40, 9 February 2023
Note: these are regimens tested in histology-specific populations, please see the main thyroid cancer page for other regimens.
0 regimens on this page
0 variants on this page
|
Guidelines
ATA
- 2015: Guidelines for the management of medullary thyroid carcinoma PubMed
ESMO
- 2019: Filetti et al. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
Older
- 2012: Pacini et al. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up PubMed
NCCN
All lines of therapy
Cabozantinib monotherapy
Regimen
Study | Years of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Kurzrock et al. 2011 (XL184-001) | 2005-2008 | Non-randomized | ||
Elisei et al. 2013 (EXAM) | 2008-2011 | Phase 3 (E-RT-esc) | Placebo | Superior PFS Median PFS: 11.2 vs 4 mo (HR 0.28, 95% CI 0.19-0.40) |
Note: To be taken at least 2 hours before or 1 hour after meals.
References
- XL184-001: Kurzrock R, Sherman SI, Ball DW, Forastiere AA, Cohen RB, Mehra R, Pfister DG, Cohen EE, Janisch L, Nauling F, Hong DS, Ng CS, Ye L, Gagel RF, Frye J, Müller T, Ratain MJ, Salgia R. Activity of XL184 (Cabozantinib), an oral tyrosine kinase inhibitor, in patients with medullary thyroid cancer. J Clin Oncol. 2011 Jul 1;29(19):2660-6. Epub 2011 May 23. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00215605
- EXAM: Elisei R, Schlumberger MJ, Müller SP, Schöffski P, Brose MS, Shah MH, Licitra L, Jarzab B, Medvedev V, Kreissl MC, Niederle B, Cohen EE, Wirth LJ, Ali H, Hessel C, Yaron Y, Ball D, Nelkin B, Sherman SI. Cabozantinib in progressive medullary thyroid cancer. J Clin Oncol. 2013 Oct 10;31(29):3639-46. Epub 2013 Sep 3. Erratum in: J Clin Oncol. 2014 Jun 10;32(17):1864. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00704730
- Update: Schlumberger M, Elisei R, Müller S, Schöffski P, Brose M, Shah M, Licitra L, Krajewska J, Kreissl MC, Niederle B, Cohen EEW, Wirth L, Ali H, Clary DO, Yaron Y, Mangeshkar M, Ball D, Nelkin B, Sherman S. Overall survival analysis of EXAM, a phase III trial of cabozantinib in patients with radiographically progressive medullary thyroid carcinoma. Ann Oncol. 2017 Nov 1;28(11):2813-2819. link to original article link to PMC article PubMed
Placebo
Regimen
Study | Years of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Wells et al. 2011 (ZETA) | 2006-2007 | Phase 3 (C) | Vandetanib | Inferior PFS |
Elisei et al. 2013 (EXAM) | 2008-2011 | Phase 3 (C) | Cabozantinib | Inferior PFS |
No active antineoplastic treatment. Included for reference purposes only.
References
- ZETA: Wells SA Jr, Robinson BG, Gagel RF, Dralle H, Fagin JA, Santoro M, Baudin E, Elisei R, Jarzab B, Vasselli JR, Read J, Langmuir P, Ryan AJ, Schlumberger MJ. Vandetanib in patients with locally advanced or metastatic medullary thyroid cancer: a randomized, double-blind phase III trial. J Clin Oncol. 2012 Jan 10;30(2):134-41. Epub 2011 Oct 24. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00410761
- EXAM: Elisei R, Schlumberger MJ, Müller SP, Schöffski P, Brose MS, Shah MH, Licitra L, Jarzab B, Medvedev V, Kreissl MC, Niederle B, Cohen EE, Wirth LJ, Ali H, Hessel C, Yaron Y, Ball D, Nelkin B, Sherman SI. Cabozantinib in progressive medullary thyroid cancer. J Clin Oncol. 2013 Oct 10;31(29):3639-46. Epub 2013 Sep 3. Erratum in: J Clin Oncol. 2014 Jun 10;32(17):1864. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00704730
Sorafenib monotherapy
Regimen
Study | Years of enrollment | Evidence |
---|---|---|
Lam et al. 2010 (OSU 06054) | 2006-2008 | Phase 2 |
References
- OSU 06054: Lam ET, Ringel MD, Kloos RT, Prior TW, Knopp MV, Liang J, Sammet S, Hall NC, Wakely PE Jr, Vasko VV, Saji M, Snyder PJ, Wei L, Arbogast D, Collamore M, Wright JJ, Moley JF, Villalona-Calero MA, Shah MH. Phase II clinical trial of sorafenib in metastatic medullary thyroid cancer. J Clin Oncol. 2010 May 10;28(14):2323-30. Epub 2010 Apr 5. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00390325
Sunitinib monotherapy
Regimen
Study | Years of enrollment | Evidence |
---|---|---|
Carr et al. 2010 | 2007-2009 | Phase 2 |
References
- Carr LL, Mankoff DA, Goulart BH, Eaton KD, Capell PT, Kell EM, Bauman JE, Martins RG. Phase II study of daily sunitinib in FDG-PET-positive, iodine-refractory differentiated thyroid cancer and metastatic medullary carcinoma of the thyroid with functional imaging correlation. Clin Cancer Res. 2010 Nov 1;16(21):5260-8. Epub 2010 Sep 16. link to original article contains dosing details in manuscript link to PMC article PubMed
Vandetanib monotherapy
Regimen variant #1, 100 mg/day
Study | Years of enrollment | Evidence |
---|---|---|
Robinson et al. 2010 (D4200C00068) | 2006-2007 | Phase 2, <20 patients |
Subsequent treatment
- At progression, eligible patients could increase the dose to 300 mg PO once per day; see paper for details
Regimen variant #2, 300 mg/day
Study | Years of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Wells et al. 2010 | 2004-2006 | Phase 2 | ||
Wells et al. 2011 (ZETA) | 2006-2007 | Phase 3 (E-RT-esc) | Placebo | Superior PFS Median PFS: NYR vs 19.3 mo (HR 0.46, 95% CI 0.31-0.69) |
References
- Wells SA Jr, Gosnell JE, Gagel RF, Moley J, Pfister D, Sosa JA, Skinner M, Krebs A, Vasselli J, Schlumberger M. Vandetanib for the treatment of patients with locally advanced or metastatic hereditary medullary thyroid cancer. J Clin Oncol. 2010 Feb 10;28(5):767-72. Epub 2010 Jan 11. link to original article contains dosing details in manuscript link to PMC article PubMed
- D4200C00068: Robinson BG, Paz-Ares L, Krebs A, Vasselli J, Haddad R. Vandetanib (100 mg) in patients with locally advanced or metastatic hereditary medullary thyroid cancer. J Clin Endocrinol Metab. 2010 Jun;95(6):2664-71. Epub 2010 Apr 6. link to original article contains dosing details in manuscript link to PMC article PubMed content property of HemOnc.org NCT00358956
- ZETA: Wells SA Jr, Robinson BG, Gagel RF, Dralle H, Fagin JA, Santoro M, Baudin E, Elisei R, Jarzab B, Vasselli JR, Read J, Langmuir P, Ryan AJ, Schlumberger MJ. Vandetanib in patients with locally advanced or metastatic medullary thyroid cancer: a randomized, double-blind phase III trial. J Clin Oncol. 2012 Jan 10;30(2):134-41. Epub 2011 Oct 24. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00410761
Advanced or metastatic disease
Axitinib monotherapy
Regimen
Study | Years of enrollment | Evidence |
---|---|---|
Locati et al. 2014 (A4061027) | 2006-2008 | Phase 2 |
References
- A4061027: Locati LD, Licitra L, Agate L, Ou SH, Boucher A, Jarzab B, Qin S, Kane MA, Wirth LJ, Chen C, Kim S, Ingrosso A, Pithavala YK, Bycott P, Cohen EE. Treatment of advanced thyroid cancer with axitinib: Phase 2 study with pharmacokinetic/pharmacodynamic and quality-of-life assessments. Cancer. 2014 Sep 1;120(17):2694-703. Epub 2014 May 20. link to original article contains dosing details in manuscript PubMed NCT00389441
Sunitinib monotherapy
Regimen
Study | Years of enrollment | Evidence | Efficacy |
---|---|---|---|
Carr et al. 2010 | 2007-2009 | Phase 2 | ORR: 31% (95% CI: 16-47) |
References
- Carr LL, Mankoff DA, Goulart BH, Eaton KD, Capell PT, Kell EM, Bauman JE, Martins RG. Phase II study of daily sunitinib in FDG-PET-positive, iodine-refractory differentiated thyroid cancer and metastatic medullary carcinoma of the thyroid with functional imaging correlation. Clin Cancer Res. 2010 Nov 1;16(21):5260-8. Epub 2010 Sep 16. link to original article contains dosing details in manuscript link to PMC article PubMed