An Effective TKI for Recurrent Medullary Thyroid Cancer: A Case Report
Thyroid World Congress ePoster Library. KAYO Y. 06/22/19; 272013; 48
YUKI KAYO
YUKI KAYO
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Abstract
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Medullary thyroid cancer is relative rare among thyroid cancer. This incidence is 3-4% and its prognosis is very miserable in generally. Because effects of antitumor drugs or irradiation including radioiodine therapy are not expected, surgical resection become central to treatment. Although we had not had effective therapeutic methods against distant metastasis or unresectable recurrent case so far, molecular targeted drugs have been able to significant extend a life prognosis recently. Vandetanib is one of tyrosine kinase inhibitors (TKI) and is the only approved molecular targeted drug against medullary thyroid drug in Japan.

 In ZETA trial examination intended for unresectable case or distant metastasis of medullary thyroid cancer, it was indicated that progression free survival rate of the patients using vandetanib prolonged in comparison to placebo statistically.

In this time, we experienced a case of medullary thyroid cancer with cervical lymph node metastasis at initial findings. The patient is 61 years old woman. Although total thyroidectomy and bilateral cervical dissection was performed, systemic multiple metastasis appeared years after operation. Therefore, we tried to administrate Vandetanib. We faced some problems like lethal arrhythmia or severe diarrhea during taking this drug. However, the patient could continue to take this drug and we could acquire good effects of being tumor-bearing as a result. We will report about this case with some literature in detail.

 


Medullary thyroid cancer is relative rare among thyroid cancer. This incidence is 3-4% and its prognosis is very miserable in generally. Because effects of antitumor drugs or irradiation including radioiodine therapy are not expected, surgical resection become central to treatment. Although we had not had effective therapeutic methods against distant metastasis or unresectable recurrent case so far, molecular targeted drugs have been able to significant extend a life prognosis recently. Vandetanib is one of tyrosine kinase inhibitors (TKI) and is the only approved molecular targeted drug against medullary thyroid drug in Japan.

 In ZETA trial examination intended for unresectable case or distant metastasis of medullary thyroid cancer, it was indicated that progression free survival rate of the patients using vandetanib prolonged in comparison to placebo statistically.

In this time, we experienced a case of medullary thyroid cancer with cervical lymph node metastasis at initial findings. The patient is 61 years old woman. Although total thyroidectomy and bilateral cervical dissection was performed, systemic multiple metastasis appeared years after operation. Therefore, we tried to administrate Vandetanib. We faced some problems like lethal arrhythmia or severe diarrhea during taking this drug. However, the patient could continue to take this drug and we could acquire good effects of being tumor-bearing as a result. We will report about this case with some literature in detail.

 


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