The role of chemotherapy and latest emerging target therapies in anaplastic thyroid cancer

Nerina Denaro,^1,2 Cristiana Lo Nigro,³ Elvio G Russi,⁴ Marco C Merlano<sup>1

1</sup>Oncology Department, AO S Croce e Carle, ²Human Pathology Department, Messina University, ³Cancer Genetics and Translational Oncology Department, ⁴Radiation Oncology Department, AO S Croce e Carle, Messina, Italy

Abstract: Anaplastic thyroid cancer represents 1%–2% of thyroid cancers. For its aggressiveness, it is considered a systemic disease at the time of diagnosis. Surgery remains the cornerstone of therapy in resectable tumor. Traditional chemotherapy has little effect on metastatic disease. A multimodality approach, incorporating cytoreductive surgical resection, chemoradiation, either concurrently or sequentially, and new promising target therapies is advisable. Doxorubicin is the most commonly used agent, with a response rate of 22%. Recently, other chemotherapy agents have been used, such as paclitaxel and gemcitabine, with superimposable activity and response rates of 10%–20%. However, survival of patients with anaplastic thyroid cancer has changed little in the past 50 years, despite more aggressive systemic and radiotherapies. Several new agents are currently under investigation. Some of them, such as sorafenib, imatinib, and axitinib have been tested in small clinical trials, showing promising disease control rates ranging from 35%–75%. Referral of patients for participation in clinical trials is needed.

Keywords: thyroid cancer, emerging therapies, anaplastic thyroid carcinoma, chemotherapy, radiotherapy