Consensus on the management of advanced medullary thyroid carcinoma on behalf of the Working Group of Thyroid Cancer of the Spanish Society of Endocrinology (SEEN) and the Spanish Task Force Group for Orphan and Infrequent Tumors (GETHI)

Endocrinol Nutr. 2015 Apr;62(4):e37-46. doi: 10.1016/j.endonu.2015.01.005. Epub 2015 Feb 26.

Abstract

Background: In Spain medullary thyroid carcinoma (MTC) would not exceed 80 new cases per year and less than half of them would be good candidates for systemic treatment with novel agents.

Methods: Relevant literature was reviewed, including PubMed searches supplemented with additional articles.

Results: The consensus summarizes the clinical outcomes in terms of activity and toxicity of each of the available drugs. A brief summary of the minimum requirements in terms of follow up and genetic counseling around MTC is also included.

Conclusions: Only those patients with objective imaging progression in the last 12-14 months with large volume of disease are clear candidates to start systemic treatment. However, those patients with low disease volume should be considered for 'wait and see' strategy until symptoms of the disease appear. Multidisciplinary approach for the management of MTC patient is mandatory nowadays.

Keywords: Antígeno carcinoembrionario; Cabozantinib; Calcitonin; Calcitonina; Carcinoembryonic antigen; Carcinoma medular de tiroides; Consenso de expertos; Cáncer de tiroides; Expert consensus; Guidelines; Guía; Medullary thyroid carcinoma; Thyroid cancer; Vandetanib.

Publication types

  • Consensus Development Conference
  • Practice Guideline

MeSH terms

  • Anilides / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Biomarkers, Tumor
  • Calcitonin / blood
  • Carcinoembryonic Antigen / analysis
  • Carcinoma, Medullary / epidemiology
  • Carcinoma, Medullary / genetics
  • Carcinoma, Medullary / therapy*
  • Combined Modality Therapy
  • Diagnostic Imaging / methods
  • Disease Management
  • Doxorubicin / therapeutic use
  • Genetic Association Studies
  • Humans
  • Neoplasm Metastasis
  • Prognosis
  • Proto-Oncogene Proteins c-ret / genetics
  • Pyridines / therapeutic use
  • Radiotherapy / methods
  • Thyroid Neoplasms / epidemiology
  • Thyroid Neoplasms / genetics
  • Thyroid Neoplasms / therapy*

Substances

  • Anilides
  • Antineoplastic Agents
  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Pyridines
  • cabozantinib
  • Doxorubicin
  • Calcitonin
  • Proto-Oncogene Proteins c-ret
  • RET protein, human