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Current Treatment Options in Oncology
Published in: Current Treatment Options in Oncology 12/2023

Open Access 18-11-2023 | Vandetanib

The Evolving Treatment Landscape of Medullary Thyroid Cancer

Authors: Marta Laganà, MD, Valentina Cremaschi, MD, Andrea Alberti, MD, Danica M. Vodopivec Kuri, MD, Deborah Cosentini, MD, Alfredo Berruti, MD

Published in: Current Treatment Options in Oncology | Issue 12/2023

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Opinion statement

Genetic assessment is crucial to address the correct treatment for advanced medullary thyroid cancer (MTC). Multi tyrosine kinase inhibitors (mTKIs) cabozantinib and vandetanib are good first line options, even vandetanib prescription is currently limited to RET mutated patients. Selective RET inhibitors such as pralsetinib could be a preferred upfront treatment in case of RET mutated MTC presenting common or gatekeeper RET mutations (e.g. M918T; V804L/M). Selpercatinib, otherwise, can be prescribed as the second line after disease progression to mTKIs. The best option for subsequent lines is to consider inclusion in clinical trials or alternatively other mTKIs such as sunitinib, sorafenib, lenvatinib, or pazopanib could be evaluated. New perspectives include next-generation RET inhibitors able to overcome resistance mechanisms responsible for disease progression to standard mTKIs and RET inhibitors, and immunotherapy for MTC presenting with high tumor mutational burden.
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Metadata
Title
The Evolving Treatment Landscape of Medullary Thyroid Cancer
Authors
Marta Laganà, MD
Valentina Cremaschi, MD
Andrea Alberti, MD
Danica M. Vodopivec Kuri, MD
Deborah Cosentini, MD
Alfredo Berruti, MD
Publication date
18-11-2023
Publisher
Springer US
Published in
Current Treatment Options in Oncology / Issue 12/2023
Print ISSN: 1527-2729
Electronic ISSN: 1534-6277
DOI
https://doi.org/10.1007/s11864-023-01145-5

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