Targeted Therapy for Advanced Thyroid Cancer: Kinase Inhibitors and Beyond.

Abstract

The treatment of advanced thyroid cancer has undergone rapid evolution in the past decade, with multiple kinase inhibitor drug approvals for each subtype of thyroid cancer and a number of other commercially available drugs that have been studied for this indication. While most of the FDA approved drugs are anti-angiogenic multikinase inhibitors-vandetanib, cabozantinib, sorafenib, lenvatinib-there are two FDA indications that are mutation specific-dabrafenib/trametinib for BRAF mutated anaplastic thyroid cancer and larotrectinib for NTRK fusion thyroid cancer. Furthermore, other mutation-specific drugs, immunotherapies, and novel strategies for advanced thyroid cancer are under investigation. Understanding the molecular basis of thyroid cancer, the drugs of interest for treatment of advanced thyroid cancer, and how these drugs can be administered safely and in the appropriate clinical scenario is the topic of this review.