• Chemotherapy for Thyroid Cancer

    Chemotherapy is the use of drugs to kill cancer cells. Unlike radiation and surgery, which are localized treatments, chemotherapy is a systemic treatment. This means that the drugs travel throughout the whole body. This means chemotherapy can reach cancer cells that may have spread, or metastasized, to other areas.
    Chemotherapy is rarely used to treat thyroid cancer. It is almost exclusively used when other treatments have failed. If chemotherapy is used, it may be combined with external radiation therapy.

    Chemotherapy Drugs Used for Thyroid Cancer

    Examples of chemotherapy drugs that may be used to treat thyroid cancer include:
    • Bleomycin (Blenoxane)
    • Dacarbazine (DTIC-Dome)
    • Docetaxel (Taxotere)
    • Doxorubicin (Adriamycin, Rubex)
    • Paclitaxel (Onxol, Taxol)
    • Platinum agents

    Effectiveness

    Researchers are still trying to determine what the benefit of chemotherapy is for various stages of thyroid cancer and its metastases. In general, surgery is more important, as is radioablation therapy . When thyroid cancer is unresponsive to these types of treatment, however, chemotherapy with or without external radiation therapy may be tried.
    If the thyroid cancer is a highly aggressive form, chemotherapy may improve survival time. Doxorubicin is the most effective single agent in this type of cancer, and it is often combined with radiation treatment.

    Adverse Reactions

    In general, the elderly and those with liver and kidney diseases are more likely to have adverse side effects. Therefore, chemotherapy drugs should be used with caution in these populations.
    Chemotherapy can cause many side effects, such as:
    • Damage to bone marrow
    • Infertility
    • Lung condition
    • Heart condition
    • Kidney condition
    • Condition affecting the nervous system
    • Nausea and vomiting
    • Hair loss
    • Diarrhea
    • Bleeding in the gastrointestinal tract
    • Altered taste or smell
    • Mouth sores

    Newer Treatment Approaches

    Researchers continue to develop and study different strategies to slow or stop the growth of tumors. For example, a drug called vandetanib has been approved by the Food and Drug Administration (FDA) to treat medullary thyroid carcinoma (MTC). Vandetanib is designed to block the action of certain cell receptors, like the vascular endothelial growth factor (VEGF) receptor. By blocking these receptors, the drug may be able to slow or stop cancer from spreading, as well as shrink tumors.
    There are a range of drugs that also inhibit growth factor receptors. The drug cabozantinib, for instance, interferes with the process that cancer cells go through to create new blood vessels, which are needed for the cancer to grow. Other treatments that are being studied include:
    • Pazopanib
    • Axitinib
    • Sunitinib
    Another example of targeted therapy includes a drug called vemurafenib. This medicine is designed to treat cancer in people who have a certain mutation in a gene called the BRAF gene. Treatment with vemurafenib has show promise in slowing cancer growth and improving mortality.

    References

    Axitinib. PubMed Health website. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0046824/. Accessed September 19, 2012.

    Baudin E, Schlumberger M. New therapeutic approaches for metastatic thyroid carcinoma. Lancet Oncol. 2007; 8:148-156

    BRAF. Genetics Home Reference website. Available at: http://ghr.nlm.nih.gov/gene/BRAF. Updated May 2012. Accessed September 19, 2012.

    Cabozantinib. Exelixis website. Available at: http://www.exelixis.com/cabozantinib. Accessed September 19, 2012.

    Cooper DS, Doherty GM, Haugen BR, et al. The American Thyroid Association Guidelines Taskforce: management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16:1-33.

    Cornett WR, Sharma AK, Day TA, et al. Anaplastic thyroid carcinoma: an overview. Curr Oncol Rep. 2007;9:152-158.

    Gupta-Abramson V, Troxel AB, Nellore A, et al. Phase II trial of sorafenib in advanced thyroid cancer. J Clin Oncol . 2008;26(29):4714-9.

    Pazopanib. PubMed Health website. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004876/. Accessed September 19, 2012.

    Sunitinib. PubMed Health website. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000402/. Accessed September 19, 2012.

    Targeted therapy shows benefit in rare type of thyroid cancer. National Cancer Institute website. Available at: http://www.cancer.gov/clinicaltrials/results/summary/2011/vandetanib1211. Accessed September 19, 2012.

    Targeted therapy for thyroid cancer. American Cancer Society website. Available at: http://www.cancer.org/Cancer/ThyroidCancer/DetailedGuide/thyroid-cancer-treating-targeted-therapy. Updated January 20, 2012. Accessed September 19, 2012.

    Zelboraf. Zelboraf website. Available at: http://www.zelboraf.com/patient/about/index.html. Accessed September 19, 2012.

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