Prognostic Value of Serum Tumor Markers in Medullary Thyroid Cancer Patients Undergoing Vandetanib Treatment
نویسندگان
چکیده
Tyrosine kinase inhibitors (TKIs) such as vandetanib have shown clinical effectiveness in advanced medullary thyroid cancer (MTC). During TKI treatment, fluctuations in the tumor markers carcinoembryonic antigen (CEA) and calcitonin (CTN) are frequently observed. Their role for treatment monitoring and the decision-making process has not been fully elucidated yet.Twenty-one patients (male, 16, female, 5; mean age, 49 ± 13 years) with progressive MTC receiving vandetanib (300 mg orally per day) were considered. Tumor restaging was performed every 3 months including contrast-enhanced computed tomography (CT). Response was assessed according to recent criteria (Response Evaluation Criteria in Solid Tumors, RECIST 1.1). Additionally, CEA and CTN were measured at the day of CT imaging and alterations observed in tumor markers were compared to respective imaging findings (partial response, PR; stable disease, SD; progressive disease, PD).During long-term follow-up (510 ± 350 days [range, 97-1140 days]), CTN and CEA levels initially dropped in 71.4% and 61.9% of the patients followed by fluctuations in serum marker levels. A rise in CTN ≥39.5% between 2 subsequent measurements (defined by ROC analysis) had a sensitivity of 70.6% and a specificity of 83.2% in predicting PD with an accuracy of 82.0% (area under the curve (AUC), 0.76). Oscillations in CEA levels were not predictive for PD.Whereas tumor marker fluctuations in MTC patients undergoing TKI treatment are a frequent phenomenon, a significant rise in CTN ≥40% turns out to as an early indicator of tumor progression.
منابع مشابه
Prognostic Value of Serum Tumor Markers in Medullary Thyroid Cancer Patients Undergoing Vandetanib Treatment: Erratum
متن کامل
Vandetanib for the Treatment of Metastatic Medullary Thyroid Cancer
Medullary thyroid cancer (MTC) represents an aggressive form of thyroid malignancy. Some may occur spontaneously or can be associated with Multiple Endocrine Neoplasia syndromes, or Familial Medullary Thyroid Cancer syndrome. In these patients, the protooncogene RET (rearranged during transfection) is mutated. In patients who have unresectable or metastatic disease, the long term prognosis is p...
متن کاملMedullary Thyroid Cancer: A Review
Thyroid cancer is a malignancy of the thyroid parenchymal cells. There are four main types of thyroid cancer: papillary thyroid cancer (PTC), follicular thyroid cancer (FTC), anaplastic thyroid carcinoma (ATC), and Medullary thyroid carcinoma (MTC). Medullary thyroid cancer (MTC) is a rare neuroendocrine tumor of the thyroid gland derived from parafollicular C-cells that produce calcitonin (CT...
متن کاملSafety and efficacy of vandetanib in the treatment of medullary thyroid cancer
Medullary thyroid cancer (MTC) is a rare malignancy affecting the calcitonin producing cells of the thyroid gland. Surgery is the mainstay of treatment in early stages. However in advanced or metastatic disease, there are few efficacious therapies. Recently emerging targeted treatments have shown promising results in this disease. Two such therapies, vandetanib and cabozantinib, have recently b...
متن کاملVandetanib in children and adolescents with multiple endocrine neoplasia type 2B associated medullary thyroid carcinoma.
PURPOSE Medullary thyroid carcinoma (MTC) is a manifestation of multiple endocrine neoplasia type 2 (MEN2) syndromes caused by germline, activating mutations in the RET (REarranged during Transfection) proto-oncogene. Vandetanib, a VEGF and EGF receptor inhibitor, blocks RET tyrosine kinase activity and is active in adults with hereditary MTC. EXPERIMENTAL DESIGN We conducted a phase I/II tri...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 94 شماره
صفحات -
تاریخ انتشار 2015