内容紹介
Anti-Cancer Drugs for Thyroid Cancer
Summary
For patients with differentiated thyroid cancer that is refractory to radioiodine therapy, a long-term response with conventional cytostatic drugs is uncommon, and treatment options have historically been limited. Outcomes for these patients have accordingly been limited.
Development of molecular-targeted drugs for thyroid cancer has recently progressed, and several drugs have demonstrated significantly improved progression-free survival over placebo in randomized phase Ⅲ trials. Nothing will bring us greater pleasure than meeting this hitherto unmet need for thyroid cancer. However, the majority of recurrent thyroid cancer patients have slow growing and asymptomatic disease, and these molecular-targeted drugs are not definitely indicated for all cases. Furthermore, toxicity is considerable and the expected treatment duration is more than one year. Without appropriate management of toxicity and patient education, these drugs will worsen quality of life.
要旨
再発を有する甲状腺癌患者がヨード治療不応になった場合は,有効な抗がん剤もなく,予後は限られる。最近,甲状腺癌にも分子標的治療薬の開発が進み,第Ⅲ相試験にてプラセボと比較して統計学的に有意に無増悪生存(PFS)を延長させる報告が相次いでいる。これまで有効な薬剤がなかった甲状腺癌にもようやく新薬が誕生したことは,たいへん喜ばしいことである。しかし,再発を来しても非常にゆっくり増大し,無症状である場合もあり,すべての再発患者が適応になるわけではない。また,副作用も決して軽いとはいえず,投与期間も1年以上になることもあることから,適切な支持療法の実践,適切な患者教育をしなければ,かえって患者のQOLを悪化させることになる。
目次
Summary
For patients with differentiated thyroid cancer that is refractory to radioiodine therapy, a long-term response with conventional cytostatic drugs is uncommon, and treatment options have historically been limited. Outcomes for these patients have accordingly been limited.
Development of molecular-targeted drugs for thyroid cancer has recently progressed, and several drugs have demonstrated significantly improved progression-free survival over placebo in randomized phase Ⅲ trials. Nothing will bring us greater pleasure than meeting this hitherto unmet need for thyroid cancer. However, the majority of recurrent thyroid cancer patients have slow growing and asymptomatic disease, and these molecular-targeted drugs are not definitely indicated for all cases. Furthermore, toxicity is considerable and the expected treatment duration is more than one year. Without appropriate management of toxicity and patient education, these drugs will worsen quality of life.
要旨
再発を有する甲状腺癌患者がヨード治療不応になった場合は,有効な抗がん剤もなく,予後は限られる。最近,甲状腺癌にも分子標的治療薬の開発が進み,第Ⅲ相試験にてプラセボと比較して統計学的に有意に無増悪生存(PFS)を延長させる報告が相次いでいる。これまで有効な薬剤がなかった甲状腺癌にもようやく新薬が誕生したことは,たいへん喜ばしいことである。しかし,再発を来しても非常にゆっくり増大し,無症状である場合もあり,すべての再発患者が適応になるわけではない。また,副作用も決して軽いとはいえず,投与期間も1年以上になることもあることから,適切な支持療法の実践,適切な患者教育をしなければ,かえって患者のQOLを悪化させることになる。