Consensus on the management of advanced medullary thyroid carcinoma on behalf of the Working Group of Thyroid Cancer of the Spanish Society of Endocrinology (SEEN) and the Spanish Task Force Group for Orphan and Infrequent Tumors (GETHI).
Galofré JC (1), Santamaría Sandi J (2), Capdevila J (3), Navarro González E (4), Zafón Llopis C (5), Ramón Y Cajal Asensio T (6), Gómez Sáez JM (7), Jiménez-Fonseca P (8), Riesco Eizaguirre G (9), Grande E (10).
(1) Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain. Electronic address: firstname.lastname@example.org.
(2) Service of Endocrinology and Nutrition, Hospital Universitario de Cruces, Vizcaya, Spain.
(3) Service of Medical Oncology, Hospital Universitario de la Vall d'Hebron, Barcelona, Spain.
(4) Service of Endocrinology and Nutrition, Hospital Universitario Virgen del Rocio, Sevilla, Spain.
(5) Service of Endocrinology and Nutrition, Hospital Universitario de la Vall d'Hebron, Barcelona, Spain.
(6) Service of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
(7) CIBERDEM Service of Endocrinology and Nutrition, Hospital Universitario de Bellvitge, Spain.
(8) Service of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain.
(9) Service of Endocrinology and Nutrition, Hospital Universitario de Móstoles, Madrid, Spain.
(10) Service of Medical Oncology, Hospital Ramón y Cajal, Madrid, Spain.
In Spain medullary thyroid carcinoma (MTC) would not exceed 80 new cases per year and less than half of them would be good candidates for systemic treatment with novel agents.
Relevant literature was reviewed, including PubMed searches supplemented with additional articles.
The consensus summarizes the clinical outcomes in terms of activity and toxicity of each of the available drugs. A brief summary of the minimum requirements in terms of follow up and genetic counseling around MTC is also included.
Only those patients with objective imaging progression in the last 12-14 months with large volume of disease are clear candidates to start systemic treatment. However, those patients with low disease volume should be considered for 'wait and see' strategy until symptoms of the disease appear. Multidisciplinary approach for the management of MTC patient is mandatory nowadays.
CITATION Endocrinol Nutr. 2015 Apr;62(4):e37-46. doi: 10.1016/j.endonu.2015.01.005. Epub 2015 Feb 26.