New Therapies Favored over Old in Thyroid Cancer

By Magill-Lewis, Jillene | Drug Topics, July 23, 2007 | Go to article overview

New Therapies Favored over Old in Thyroid Cancer


Magill-Lewis, Jillene, Drug Topics


Tried-and-true drugs may not necessarily be the best, at least when it comes to certain types of thyroid cancer. The National Comprehensive Cancer Network (NCCN) has updated the clinical practice guidelines for thyroid carcinoma.

For thyroid cancers that have metastasized to other areas of the body, conventional chemotherapy agents may not be the best choice. "Cytotoxic chemotherapy has been shown to have minimal efficacy," NCCN stated in the guidelines. Patients would be better off enrolling in a clinical trial investigating one of the new, novel targeted therapies, according to NCCN.

According to Steven I. Sherman, M.D., associate professor at the University of Texas M. D. Anderson Cancer Center and chair of the NCCN thyroid carcinoma panel, years of research will be required before any new drugs receive approval for thyroid cancer, but patients can still benefit from some potentially promising new therapies by enrolling in a trial. There are several drugs under investigation for efficacy in thyroid cancer. One drug has made it to phase IU studies. Most of the drugs are still in phase II clinical studies, and a few are in phase I. Here's a roundup of the candidates:

* Sodium iodide I-131 (Draxlmage) is a radioactive iodine already approved for use in evaluating thyroid function and for localization of cancer that has metastasized outside the thyroid. The radiation from iodine 1-131 kills thyroid cancer cells, and a couple of phase III studies are evaluating just how well the drug performs in people with thyroid cancer.

* Multikinase inhibitors interfere with multiple kinase enzymes that are used by tumor cells to grow and multiply. Sunitinib (Sutent, Pfizer) and sorafenib (Nexavar, Bayer/ Onyx) are multikinase inhibitors already approved to treat other cancers. Both are in phase I trials for thyroid cancer.

* Tanespimycin (Kosan Biosciences), also known as KOS-953 or 17-AAG, is a geldanamycin analog that binds to heat-shock protein 90 (HSP90). Binding to HSP90 results in the downregulation of a number of proteins, including tyrosine kinases and transcription factors, and thereby causes cancer cell death. According to Kosan, tanespimycin is in phase II trials for thyroid cancer as monotherapy and in combination with bortezomib (Velcade, Millennium), a proteosome inhibitor that is already approved for multiple myeloma. There is a lot of interest in this drug as an addition to other drug regimens as well as monotherapy for thyroid cancer. …

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