Page 47 - Read Online

Page 14 of 19 Matrone et al. J Cancer Metastasis Treat 2021;7:23 https://dx.doi.org/10.20517/2394-4722.2021.47

MTC who experienced no benefit with other therapies and express SSTr as assessed with a diagnostic tool
exploring the presence of these receptors.

CONCLUSION
MTC is a rare disease with a high risk of not being cured by the initial treatment. Nowadays, advanced and
progressive MTC can be treated with at least two different types of TKI, vandetanib and cabozantinib. The
choice is highly dependent on the availability of the drug; the location of the metastases; the need to have a
more or less rapid response; the patient clinical features, such as the presence of diverticulitis or congenital
QTc prolongation; and the experience of the medical team. In the near future, a second generation of TKI,
which are much more selective for RET mutations and almost harmless, will be available in clinical practice,
while other even more selective and mutation specific drugs are under development. The limit of these last
generation drugs is that they cannot be used in RET-negative cases, which represent almost 40% of cases.

Immunotherapy, although promising, is still unavailable for MTC patients, while some therapeutic space is
possible for radiometabolic therapy with radiolabeled analogs of somatostatin in those cases that are positive
for the corresponding receptor, especially if no other therapeutic options are possible.

DECLARATIONS
Authors’ contributions
Conceptualization: Matrone A, Elisei R
Methodology: Matrone A, Gambale C, Prete A, Elisei R
Original draft preparation: Matrone A, Gambale C, Prete A
Review and editing: Cappagli V, Lorusso L, Bottici V
Final editing: Matrone A, Elisei R
Supervision: Elisei R
All authors have read and agreed to the published version of the manuscript.

Availability of data and materials
Not applicable.

Financial support and sponsorship
This study has been supported by grants to R.E. from Associazione Italiana per la Ricerca sul Cancro
(AIRC, Investigator grant 2018, project code 21790. Title: NEW INSIGHTS IN THE GENETIC PROFILE
OF MEDULLARY THYROID CARCINOMA), Agenzia Italiana del Farmaco (AIFA, project code AIFA-
2016- 02365049. Title: Circulating microRNAs and DNA (cfDNA) as novel biomarkers for diagnostic,
prognostic and therapeutic use in Medullary Thyroid Carcinoma).

Conflict of interest
Elisei R is consultant for Eisai, Loxo, Ipsen, Lilly, but the content of this paper was not influenced by this
activity.
All the other authors declared that there have no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.