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Partial remission of metastatic papillary thyroid carcinoma with sunitinib. Report of a case and review of the literature

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Abstract

Tyrosine kinase receptors have been implicated in thyroid cancer. Therefore, tyrosine kinase inhibitors may be used for the treatment of advanced metastatic thyroid carcinoma. The aim is to present a case of metastatic papillary thyroid carcinoma responding to the administration of sunitinib, a multi-targeted protein kinase inhibitor. A patient presented with metastatic papillary thyroid carcinoma and hyperthyroidism. After euthyroidism was achieved the patient was treated by the administration of therapeutic radioiodine 131I, radiotherapy and sunitinib, a multi-targeted tyrosine kinase inhibitor. Thyroglobulin levels decreased from 9,594 to 6,816 ng/ml after 1 month, 6 months later being 2,776 ng/ml. The lesion in the pelvis was 12.5 × 9 cm before treatment decreasing thereafter and the patient improved clinically. The administration of sunitinib resulted in partial disease response in a patient with progressive metastatic papillary thyroid carcinoma. Protein kinase inhibitors may prove useful in the management of advanced metastatic papillary thyroid carcinoma.

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References

  1. A. Jemal, T. Murray, E. Ward, A. Samuels, R.C. Tiwari, A. Ghafoor, E.J. Feuer, M.J. Thun, Cancer statistics, 2005. CA Cancer J. Clin. 55, 10–30 (2005)

    Article  PubMed  Google Scholar 

  2. L. Davies, J.G. Welch, Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 295, 2164–2167 (2006)

    Article  CAS  PubMed  Google Scholar 

  3. D.S. Cooper, G.M. Doherty, B.R. Haugen, R.T. Kloos, S.L. Lee, S.J. Mandel, E.L. Mazzaferri, B. McIver, S.I. Sherman, R.M. Tuttle, The American Thyroid Association Guidelines Taskforce, Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 16, 109–142 (2006)

    Article  PubMed  Google Scholar 

  4. B.R. Haugen, Management of the patient with progressive radioiodine non-responsive disease. Semin. Surg. Oncol. 16, 34–41 (1999)

    Article  CAS  PubMed  Google Scholar 

  5. K. Shimaoka, D. Schoenfeld, W.D. DeWys, R.H. Greech, R. DeConti, A randomized trial of doxorubicin versus doxorubicin plus cisplatin in patients with advanced thyroid carcinoma. Cancer 56, 2155–2160 (1985)

    Article  CAS  PubMed  Google Scholar 

  6. P. De Besi, B. Busnardo, S. Toso, M.E. Girelli, D. Nacamulli, N. Simioni, D. Casara, P. Zorat, M.V. Fiorentino, Combined chemotherapy with bleomycin, adriamycin, and platinum in advanced thyroid cancer. J. Endocrinol. Invest. 14, 475–480 (1991)

    PubMed  Google Scholar 

  7. T. Kondo, S. Ezzat, S.L. Asa, Pathogenetic mechanisms in thyroid follicular-cell neoplasia. Nat. Rev. Cancer 6, 292–306 (2006)

    Article  CAS  PubMed  Google Scholar 

  8. M. Santoro, F. Carlomagno, Drug insight: small-molecule inhibitors of protein kinases in the treatment of thyroid cancer. Natl Clin. Pract. Endocrinol. Metab. 2, 42–52 (2006)

    Article  CAS  Google Scholar 

  9. M.D. Castellone, F. Carlomagno, G. Salvatore, M. Santoro, Receptor tyrosine kinase inhibitors in thyroid cancer. Best Pract. Res. Clin. Endocrinol. Metab. 22, 1023–1038 (2008)

    Article  CAS  PubMed  Google Scholar 

  10. J.A. Fagin, How thyroid tumors start and why it matters: kinase mutants as targets for solid cancer pharmacotherapy. J. Endocrinol. 183, 249–256 (2004)

    Article  CAS  PubMed  Google Scholar 

  11. S. Trovisco, P. Soares, M. Sobrinho-Simoes, B-RAF mutations in the etiopathogenesis, diagnosis, and prognosis of thyroid carcinomas. Human Pathol. 37, 781–786 (2006)

    Article  CAS  Google Scholar 

  12. R.L. Brown, C. Ezra, Tyrosine kinase inhibition: novel treatment for advanced thyroid cancer. Rev. Endocrinol. 8, 21–24 (2008)

    Google Scholar 

  13. D.W. Kim, Y.S. Jo, H.S. Jung, H.K. Chung, J.H. Song, K.C. Park, S.H. Park, J.H. Hwang, S.Y. Rha, G.R. Kweon, S.J. Lee, K.W. Jo, M. Shong, An orally administered multitarget tyrosine kinase inhibitor, SU11248, is a novel potent inhibitor of thyroid oncogenic RET/papillary thyroid cancer kinases. J. Clin. Endocrinol. Metab. 91, 4070–4076 (2006)

    Article  CAS  PubMed  Google Scholar 

  14. T.M. de Reijke, J. Bellmunt, H. van Poppel, S. Marreaud, M. Aapro, EORTC-GU group expert opinion on metastatic renal cell cancer. Eur. J. Cancer 45, 765–773 (2009)

    Article  PubMed  Google Scholar 

  15. Anonymous, Sunitinib: new drug. For some gastrointestinal stromal tumours. Prescribe Int. 16, 138–141 (2007)

  16. D.R. Robinson, Y.M. Wu, S.F. Lin, The protein tyrosine kinase family of the human genome. Oncogene 19, 5548–5557 (2000)

    Article  CAS  PubMed  Google Scholar 

  17. E. Zwick, J. Bange, A. Ullrich, Receptor tyrosine kinase signalling as a target for cancer intervention strategies. Endocr. Relat. Cancer 8, 161–173 (2001)

    Article  CAS  PubMed  Google Scholar 

  18. R.H. Gunby, E. Sala, C.J. Tartari, M. Puttini, C. Gambacorti-Passerini, L. Mologni, Oncogenic fusion tyrosine kinases as molecular targets for anti-cancer therapy. AntiCancer Agents Med. Chem. 7, 594–611 (2007)

    Article  CAS  PubMed  Google Scholar 

  19. P. Soares, V. Trovisco, A.S. Rocha, J. Lima, P. Castro, A. Preto, V. Máximo, T. Botelho, R. Seruca, M. Sobrinho-Simões, BRAF mutations and RET/PTC rearrangements are alternative events in the etiopathogenesis of PTC. Oncogene 22, 4578–4580 (2003)

    Article  CAS  PubMed  Google Scholar 

  20. D.G. Pfister, J.A. Fagin, Refractory thyroid cancer: a paradigm shift in treatment is not far off. J. Clin. Oncol. 26, 4701–4704 (2008)

    Article  CAS  PubMed  Google Scholar 

  21. M. Santoro, R.M. Melillo, F. Carlomagno, A. Fusco, G. Vecchio, Molecular mechanisms of RET activation in human cancer. Ann. NY Acad. Sci. 963, 116–121 (2002)

    Article  CAS  PubMed  Google Scholar 

  22. M. Grieco, M. Santoro, M.T. Berlingieri, R.M. Melillo, R. Donghi, I. Borganzone, M.A. Pierotti, G. Della Porta, A. Fusco, G. Vecchio, PTC is a novel rearranged form of the ret proto-oncogene and is frequently detected in vivo in human thyroid papillary carcinomas. Cell 60, 557–563 (1990)

    Article  CAS  PubMed  Google Scholar 

  23. E. Baudin, M. Schlumberger, New therapeutic approaches for metastatic thyroid carcinoma. Lancet Oncol. 8, 148–156 (2007)

    Article  CAS  PubMed  Google Scholar 

  24. P. Kundra, K.D. Burman, Thyroid cancer molecular signaling pathways and use of targeted therapy. Endocrinol. Metab. Clin. North Am. 36, 839–853 (2007)

    Article  CAS  PubMed  Google Scholar 

  25. S.M. Coehlo, D.P. de Carvahlo, M. Vaisman, New perspectives on the treatment of differentiated thyroid cancer. Arq. Bras. Endocrinol. Metab. 51, 612–624 (2007)

    Google Scholar 

  26. G. Malouf, E. Baudin, J.C. Soria, M. Schlumberger, Advances in the treatment of thyroid cancer in the era of molecularly targeted therapies. Bull. Cancer 96, 95–101 (2009)

    CAS  PubMed  Google Scholar 

  27. S.I. Sherman, Advances in chemotherapy of differentiated epithelial and medullary thyroid cancers. J. Clin. Endocrinol. Metab. 94, 1493–1499 (2009)

    Article  CAS  PubMed  Google Scholar 

  28. J.K. Smith, N.M. Mamoun, R.J. Duhe, Emerging roles of targeted small molecule protein-kinase inhibitors in cancer therapy. Oncol. Res. 14, 175–225 (2004)

    PubMed  Google Scholar 

  29. C. Lanzi, G. Cassinelli, T. Pensa, M. Cassinis, R.A. Gambetta, M.G. Borrello, E. Menta, M.A. Pierrotti, F. Zunino, Inhibition of transforming activity of the ret/ptc1 oncoprotein by a 2-indolinone derivative. Int. J. Cancer 85, 384–390 (2000)

    Article  CAS  PubMed  Google Scholar 

  30. D.B. Mendel, A.D. Laird, X. Xin, S.G. Louie, J.G. Christensen, G. Li, R.E. Schreck, T.J. Abrams, T.J. Ngai, L.B. Lee, L.J. Murray, J. Carver, E. Chan, K.G. Moss, J.O. Haznedar, J. Sukbuntherng, R.A. Blake, L. Sun, C. Tang, T. Miller, S. Shirazian, G. McMahon, J.M. Cherrington, In vivo antitumor activity of SU11248, a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor and platelet-derived growth factor receptors: determination of a pharmacokinetic/pharmacodynamic relationship. Clin. Cancer Res. 9, 327–337 (2003)

    CAS  PubMed  Google Scholar 

  31. L.Q. Chow, S.G. Eckhardt, Sunitinib: from rational design to clinical efficacy. J. Clin. Oncol. 25, 884–896 (2007)

    Article  CAS  PubMed  Google Scholar 

  32. P. Wolter, C. Stefan, B. Decallonne, H. Dumez, M. Bex, P. Carmeliet, P. Schöffski, The clinical implications of sunitinib-induced hypothyroidism: a prospective evaluation. Br. J. Cancer 99, 448–454 (2008)

    Article  CAS  PubMed  Google Scholar 

  33. R. Cohen, H. Bihan, B. Uzzan, G. des Guetz, A. Krivitzky, Sunitinib and hypothyroidism. Ann. Endocrinol. (Paris) 68, 332–336 (2007)

    CAS  Google Scholar 

  34. B.I. Rini, I. Tamaskar, P. Shaheen, R. Salas, J. Garcia, L. Wood, S. Reddy, R. Dreicer, R.M. Bukowski, Hypothyroidism in patients with metastatic renal cell carcinoma treated with sunitinib. J. Natl Cancer Inst. 99, 81–83 (2007)

    Article  CAS  PubMed  Google Scholar 

  35. M. Grossmann, E. Premaratne, J. Desai, I.D. Davis, Thyrotoxicosis during sunitinib treatment for renal cell carcinoma. Clin. Endocrinol. (Oxf) 69, 669–672 (2008)

    Article  CAS  Google Scholar 

  36. J.E. Faris, A.F. Moore, G.H. Daniels, Sunitinib (sutent)-induced thyrotoxicosis due to destructive thyroiditis: a case report. Thyroid 17, 1147–1149 (2007)

    Article  PubMed  Google Scholar 

  37. E. Wong, L.S. Rosen, M. Mulay, A. Vanvugt, M. Dinolfo, C. Tomoda, M. Sugawara, J.M. Hershman, Sunitinib induces hypothyroidism in advanced cancer patients and may inhibit thyroid peroxidase activity. Thyroid. 17, 351–355 (2007)

    Article  CAS  PubMed  Google Scholar 

  38. E.A. Eisenhauer, P. Therasse, J. Bogaerts, L.H. Schwartz, D. Sargent, R. Ford, J. Dancey, S. Arbuck, S. Gwyther, M. Mooney, L. Rubinstein, L. Shankar, L. Dodd, R. Kaplan, D. Lacombe, J. Verweij, New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur. J. Cancer 45, 228–247 (2009)

    Article  CAS  PubMed  Google Scholar 

  39. S.J. Dawson, N.M. Conus, G.C. Toner, J.M. Raleigh, R.J. Hicks, G. McArthur, D. Rischin, Sustained clinical responses to tyrosine kinase inhibitor sunitinib in thyroid carcinoma. Anticancer Drugs 19, 547–552 (2008)

    Article  CAS  PubMed  Google Scholar 

  40. E.E. Cohen, B.M. Needles, K.J. Cullen, S.J. Wong, J.L. Wade, S.P. Ivy, V.M. Villaflor, T.Y. Seiwert, K. Nichols, E.E. Vokes, Phase 2 study of sunitinib in refractory thyroid cancer. J. Clin. Oncol. 26(suppl), 6025 (2008). (abstr)

    Google Scholar 

  41. A. Ravaud, C. de la Fouchardière, F. Courbon, J. Asselineau, M. Klein, P. Nicoli-Sire, C. Bournaud, J. Delord, G. Weryha, B. Catargi, Sunitinib in patients with refractory advanced thyroid cancer: the THYSU phase II trial. J. Clin. Oncol. 26(suppl), 6058 (2008). (abstr)

    Google Scholar 

  42. F.C. Kelleher, R. McDermott, Response to sunitinib in medullary thyroid cancer. Ann. Intern. Med. 148, 567 (2008)

    PubMed  Google Scholar 

  43. M.J. Bugalho, R. Domingues, A. Borges, Case report: a case of advanced medullary thyroid carcinoma successfully treated with sunitinib. Oncologist 14, 1083–1087 (2009)

    Article  PubMed  Google Scholar 

  44. N. Steeghs, J.W. Nortier, H. Gelderblom, Small molecule tyrosine kinase inhibitors in the treatment of solid tumors: an update of recent developments. Ann. Surg. Oncol. 14, 942–953 (2007)

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Endocrinology, Metaxa Hospital, 51 Botassi Street, 18537, Piraeus, Greece

    Ph. Kaldrymides, A. Gkountouvas & E. Veniou

  2. Department of Endocrinology, Metaxa Hospital, Piraeus, 7 Korinthias Street, 11526, Athens, Greece

    I. Kostoglou-Athanassiou

  3. Department of Internal Medicine, Metaxa Hospital, Piraeus, Greece

    N. Ziras

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  1. Ph. Kaldrymides
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Correspondence to I. Kostoglou-Athanassiou.

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Kaldrymides, P., Kostoglou-Athanassiou, I., Gkountouvas, A. et al. Partial remission of metastatic papillary thyroid carcinoma with sunitinib. Report of a case and review of the literature. Endocr 37, 6–10 (2010). https://doi.org/10.1007/s12020-009-9290-z

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