Thyroid cancer

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Note: most thyroid cancer regimens can be found on dedicated pages:

• Histology-specific:
  • Differentiated thyroid cancer (DTC)
  • Medullary thyroid cancer
• Biomarker-specific:
  • BRAF-mutated thyroid cancer
  • RET-positive thyroid cancer

3 regimens on this page 3 variants on this page

Guidelines

Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.

ATA

• 2015: Guidelines on the management of thyroid nodules and differentiated thyroid cancer PubMed
• 2015: Guidelines for the management of medullary thyroid carcinoma PubMed
• 2012: Guidelines for management of patients with anaplastic thyroid cancer PubMed

ESMO

• 2019: Filetti et al. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up PubMed
  • 2012: Pacini et al. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up PubMed
  • 2010: Pacini et al. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up PubMed

NCCN

• NCCN Guidelines - Thyroid Carcinoma

• 2015: Haddad et al. Anaplastic Thyroid Carcinoma, Version 2.2015 PubMed
• 2014: Tuttle et al. Thyroid Carcinoma, Version 2.2014 PubMed
• 2010: Tuttle et al. Thyroid carcinoma. PubMed
• 2007: Sherman et al. Thyroid carcinoma. PubMed
• 2005: Sherman et al. Thyroid carcinoma. PubMed

Advanced or metastatic disease

Axitinib monotherapy

Regimen

Study	Dates of enrollment	Evidence
Cohen et al. 2008 (A4061014)	NR	Phase 2

Targeted therapy

• Axitinib (Inlyta) 5 mg PO twice per day

Continued indefinitely

References

1. A4061014: Cohen EE, Rosen LS, Vokes EE, Kies MS, Forastiere AA, Worden FP, Kane MA, Sherman E, Kim S, Bycott P, Tortorici M, Shalinsky DR, Liau KF, Cohen RB. Axitinib is an active treatment for all histologic subtypes of advanced thyroid cancer: results from a phase II study. J Clin Oncol. 2008 Oct 10;26(29):4708-13. Epub 2008 Jun 9. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00094055
   1. Update: Cohen EE, Tortorici M, Kim S, Ingrosso A, Pithavala YK, Bycott P. A Phase II trial of axitinib in patients with various histologic subtypes of advanced thyroid cancer: long-term outcomes and pharmacokinetic/pharmacodynamic analyses. Cancer Chemother Pharmacol. 2014 Dec;74(6):1261-70. Epub 2014 Oct 15. link to original article link to PMC article PubMed

Doxorubicin monotherapy

Regimen

Study	Evidence
Gottlieb et al. 1974	Non-randomized

Note: This is of historic interest.

Chemotherapy

• Doxorubicin (Adriamycin)

References

1. Gottlieb JA, Hill CS Jr. Chemotherapy of thyroid cancer with adriamycin: experience with 30 patients. N Engl J Med. 1974 Jan 24;290(4):193-7. link to original article PubMed

Sorafenib monotherapy

Regimen

Study	Evidence	Efficacy
Gupta-Abramson et al. 2008	Phase 2	ORR: 23% (95% CI, 10-42)

Targeted therapy

• Sorafenib (Nexavar) 400 mg PO twice per day on days 1 to 28

28-day cycles

References

1. Gupta-Abramson V, Troxel AB, Nellore A, Puttaswamy K, Redlinger M, Ransone K, Mandel SJ, Flaherty KT, Loevner LA, O'Dwyer PJ, Brose MS. Phase II trial of sorafenib in advanced thyroid cancer. J Clin Oncol. 2008 Oct 10;26(29):4714-9. Epub 2008 Jun 9. link to original article contains dosing details in manuscript link to PMC article PubMed