乐伐替尼在治疗放射性碘难治性分化型甲状腺癌症中的应用:日常实践的多学科视角。

IF 3.5 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM European Thyroid Journal Pub Date : 2023-08-08 DOI:10.1530/ETJ-23-0068
Jaume Capdevila, Desiree' Deandreis, Cosimo Durante, Sophie Leboulleux, Markus Luster, Romana Netea-Maier, Kate Newbold, Susanne Singer, Gerasimos P Sykiotis, Beate Bartes, Kate Farnell, Laura Deborah Locati
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引用次数: 0

摘要

背景:大多数滤泡性甲状腺癌都有良好的预后。只有一小部分患者会发展为转移性疾病,其中一些会成为放射性碘难治性疾病(RAI-R)。确保最佳治疗结果的重要挑战包括正确、及时和适当的诊断;关于局部、系统治疗的决定;治疗副作用的管理;以及专家、患者和护理人员之间的良好关系。方法:为了提供在日常实践中有用的建议,一个多学科专家组根据他们与正在接受乐伐替尼治疗的RAI-R分化型癌症(DTC)患者的共同临床经验,组织了以下文件。涵盖的主要领域包括患者选择、治疗开始、随访和不良事件管理。结论:必须为RAI-R DTC患者的全身治疗管理提供指导,尤其是乐伐替尼,因为依从性和坚持治疗是获得最佳结果的基础。虽然RAI-R DTC的治疗前景正在演变,但随着新的靶向疗法、免疫疗法等的出现,乐伐替尼有望在未来几年内继续成为绝大多数患者和环境中的一线治疗和主要治疗药物。本文的指导涵盖了基线检查和系统治疗的开始、症状的相关性、多学科评估和患者教育。还提供了基于专家经验的实用信息,用于乐伐替尼的起始剂量、随访和监测,以及不良事件的管理、停药和重新开始治疗。还强调了患者参与的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Use of lenvatinib in the treatment of radioiodine-refractory differentiated thyroid cancer: a multidisciplinary perspective for daily practice.

Background: Most thyroid cancers of follicular origin have a favorable outcome. Only a small percentage of patients will develop metastatic disease, some of which will become radioiodine refractory (RAI-R). Important challenges to ensure the best therapeutic outcomes include proper, timely, and appropriate diagnosis; decisions on local, systemic treatments; management of side effects of therapies; and a good relationship between the specialist, patients, and caregivers.

Methods: With the aim of providing suggestions that can be useful in everyday practice, a multidisciplinary group of experts organized the following document, based on their shared clinical experience with patients with RAI-R differentiated thyroid cancer (DTC) undergoing treatment with lenvatinib. The main areas covered are patient selection, initiation of therapy, follow-up, and management of adverse events.

Conclusions: It is essential to provide guidance for the management of RAI-R DTC patients with systemic therapies, and especially lenvatinib, since compliance and adherence to treatment are fundamental to achieve the best outcomes. While the therapeutic landscape in RAI-R DTC is evolving, with new targeted therapies, immunotherapy, etc., lenvatinib is expected to remain a first-line treatment and mainstay of therapy for several years in the vast majority of patients and settings. The guidance herein covers baseline work-up and initiation of systemic therapy, relevance of symptoms, multidisciplinary assessment, and patient education. Practical information based on expert experience is also given for the starting dose of lenvatinib, follow-up and monitoring, as well as the management of adverse events and discontinuation and reinitiating of therapy. The importance of patient engagement is also stressed.

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来源期刊
European Thyroid Journal
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.
期刊最新文献
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