Enhancing radioactive iodine (RAI) incorporation in RAI-refractory differentiated thyroid cancer: current insights.

IF 4.3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM European Thyroid Journal Pub Date : 2025-03-24 Print Date: 2025-04-01 DOI:10.1530/ETJ-24-0319

Tomo Hiromasa, Hiroshi Wakabayashi, Satoru Watanabe, Takafumi Yamase, Seigo Kinuya

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Abstract

Metastatic differentiated thyroid cancer (DTC) is responsible for most thyroid cancer-related deaths, with an even worse prognosis for patients with radioactive iodine (RAI)-refractory DTC (RAIR-DTC). While multikinase inhibitors (MKIs) and tyrosine kinase inhibitors (TKIs) offer effective treatments for RAIR-DTC, most patients remain noncurative and eventually experience disease progression. In addition, long-term use of these medications is hindered by adverse events, drug resistance and high cost. Recently, the use of MKIs and TKIs has reignited interest in enhancing RAI incorporation. This approach aims to restore the effectiveness of RAI therapy in patients with RAIR-DTC by using agents that increase RAI uptake, potentially overcoming current treatment challenges. This review covers the molecular mechanisms behind RAI resistance, the definition of RAIR-DTC and the efforts to enhance RAI incorporation through various agents, including those currently undergoing clinical trials.

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增强放射性碘（RAI）在RAI难治性分化甲状腺癌中的掺入：最新见解。

转移分化性甲状腺癌（DTC）是大多数甲状腺癌相关死亡的原因，放射性碘（RAI）难治性DTC （RAIR-DTC）患者的预后甚至更差。虽然多激酶抑制剂（MKIs）和酪氨酸激酶抑制剂（TKIs）为RAIR-DTC提供了有效的治疗方法，但大多数患者仍然无法治愈，并最终经历疾病进展。此外，这些药物的长期使用受到不良事件、耐药性和高成本的阻碍。最近，mki和tki的使用重新激起了人们对加强RAI整合的兴趣。该方法旨在通过使用增加RAI摄取的药物来恢复RAI治疗对RAIR-DTC患者的有效性，从而潜在地克服当前的治疗挑战。本文综述了RAI耐药的分子机制，RAIR-DTC的定义，以及通过各种药物（包括目前正在进行临床试验的药物）加强RAI结合的努力。

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来源期刊

European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.70

自引率

2.10%

发文量

156

期刊介绍： The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.