Future looks bright for thyroid cancer molecular imaging, treatments

A number of research breakthroughs in molecular imaging and molecular-targeted treatments of thyroid cancer are showing signs of expansion into the clinic, according to a review in the March issue of The Lancet.

Thyroid cancer of the epithelial follicular-cell is on the rise and is the most common endocrine malignancy in the world. A little more than nine women out of 100,000 and just fewer than three men per 100,000 develop the disease, according to the review written by Mingzhao Xing, MD, from the laboratory for cellular and molecular thyroid research, at Johns Hopkins University School of Medicine in Baltimore, and colleagues. The review focused on the progress of a number of molecular imaging techniques, including the use of diagnostic biomarkers and investigational therapies to determine their progress outside the lab.

“On the basis of recently identified diagnostic and prognostic molecular markers and therapeutic targets, novel effective management strategies have been (or are being) rapidly developed for thyroid cancer,” wrote Xing et al. “With these unprecedented achievements, we have now entered an exciting modern era of molecular thyroid cancer medicine.”

The most significant developments in the past decade of molecular imaging and treatment for thyroid cancer include diagnostic and prognostic biomarkers such as a newly discovered gene expression classifier; RAS, BRAFV600E, RET-PTC other mutations; and galectin 3. Risk stratification and tailoring of individual patient management was improved by the BRAF mutation prognostic genetic marker, even for those patients with relatively low risk.

Thyroid cancer patients with radioiodine-refractory tumors who are surgically inoperable were found to benefit from molecular targeted treatments. These include kinase inhibitos, which were indicated for a potentially new standard of care for refractory thyroid cancers. New therapies coming down the pipeline could combine different drugs, such as temsirolimus and sorafenib. according to the researchers. 

“These novel molecular-based management strategies for thyroid nodules and thyroid cancer are the most exciting developments in this unprecedented era of molecular thyroid-cancer medicine,” wrote Xing and colleagues.