Abstract |
After ligand binding induces dimerization, the RET receptor tyrosine kinase activates multiple signal transduction pathways. Constitutively activating mutations and chromosomal rearrangements are the primary oncogenic event in a significant number of medullary thyroid cancers (MTC) and papillary thyroid cancers (PTC), respectively. When specific germline mutations in RET are identified early, prophylactic thyroidectomy can be timed to remove at-risk tissue in patients with multiple endocrine neoplasia 2 (MEN2) syndromes who would otherwise develop MTC. Conventional therapy for progressive metastatic MTC is limited. Small-molecule tyrosine kinase inhibitors can target multiple kinases at nanomolar concentrations, including RET, and have shown efficacy against a variety of malignancies. Initial clinical evidence suggests that several of these inhibitors, including sorafenib, vandetanib, motesanib, sunitinib, and XL-184, may have some benefit in treating progressive MTC. Although initial success seen in these trials seems to be modest, it represents a major breakthrough in the treatment of patients with widespread metastatic MTC.
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Authors | John E Phay, Manisha H Shah |
Journal | Clinical cancer research : an official journal of the American Association for Cancer Research
(Clin Cancer Res)
Vol. 16
Issue 24
Pg. 5936-41
(Dec 15 2010)
ISSN: 1557-3265 [Electronic] United States |
PMID | 20930041
(Publication Type: Journal Article, Review)
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Copyright | ©2010 AACR. |
Chemical References |
- Antineoplastic Agents
- Protein Kinase Inhibitors
- Proto-Oncogene Proteins c-ret
- RET protein, human
- Receptor Protein-Tyrosine Kinases
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Topics |
- Animals
- Antineoplastic Agents
(pharmacology, therapeutic use)
- Carcinoma, Medullary
(diagnosis, drug therapy, genetics, metabolism)
- Enzyme Activation
(drug effects, physiology)
- Genetic Association Studies
- Humans
- Models, Biological
- Molecular Targeted Therapy
(methods)
- Neoplasms
(drug therapy)
- Protein Kinase Inhibitors
(pharmacology, therapeutic use)
- Proto-Oncogene Proteins c-ret
(antagonists & inhibitors, genetics)
- Receptor Protein-Tyrosine Kinases
(antagonists & inhibitors, metabolism)
- Thyroid Neoplasms
(diagnosis, drug therapy, genetics, metabolism)
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