BACKGROUND: Treatment options for patients with advanced or metastatic medullary thyroid cancer (MTC) have, in recent years, expanded with the approval of two tyrosine kinase inhibitors (TKIs): vandetanib and cabozantinib. Other agents, including TKIs, are under clinical investigation for MTC. Although patients treated with TKIs are at risk of developing dermatologic adverse events (AE), these untoward events may be mitigated through AE-driven algorithms. SUMMARY: AE-driven algorithms combine effective nonpharmaceutical and pharmaceutical treatment modalities implemented by a multidisciplinary effort that incorporates nursing interventions, patient education, and referrals to pain-management specialists, podiatrists, and dermatologists, as appropriate. Effective AE prevention and management reduce the need for dose interruptions and modifications, allowing patients the opportunity to derive the maximal benefit from TKI therapy, while maintaining quality of life. CONCLUSIONS: Optimal use of targeted therapies in the treatment of MTC depends on careful patient selection, interdisciplinary communication, and patient education and encouragement to enhance compliance and safety, optimize consistent dosing, and maximize the use of effective therapies.
BACKGROUND: Treatment options for patients with advanced or metastatic medullary thyroid cancer (MTC) have, in recent years, expanded with the approval of two tyrosine kinase inhibitors (TKIs): vandetanib and cabozantinib. Other agents, including TKIs, are under clinical investigation for MTC. Although patients treated with TKIs are at risk of developing dermatologic adverse events (AE), these untoward events may be mitigated through AE-driven algorithms. SUMMARY: AE-driven algorithms combine effective nonpharmaceutical and pharmaceutical treatment modalities implemented by a multidisciplinary effort that incorporates nursing interventions, patient education, and referrals to pain-management specialists, podiatrists, and dermatologists, as appropriate. Effective AE prevention and management reduce the need for dose interruptions and modifications, allowing patients the opportunity to derive the maximal benefit from TKI therapy, while maintaining quality of life. CONCLUSIONS: Optimal use of targeted therapies in the treatment of MTC depends on careful patient selection, interdisciplinary communication, and patient education and encouragement to enhance compliance and safety, optimize consistent dosing, and maximize the use of effective therapies.
Authors: L M Mulligan; J B Kwok; C S Healey; M J Elsdon; C Eng; E Gardner; D R Love; S E Mole; J K Moore; L Papi Journal: Nature Date: 1993-06-03 Impact factor: 49.962
Authors: Mauro Papotti; Martina Olivero; Marco Volante; Francesco Negro; Maria Prat; Paolo M. Comoglio; Maria Flavia DiRenzo Journal: Endocr Pathol Date: 2000 Impact factor: 3.943
Authors: Nishant Agrawal; Yuchen Jiao; Mark Sausen; Rebecca Leary; Chetan Bettegowda; Nicholas J Roberts; Sheetal Bhan; Allen S Ho; Zubair Khan; Justin Bishop; William H Westra; Laura D Wood; Ralph H Hruban; Ralph P Tufano; Bruce Robinson; Henning Dralle; Sergio P A Toledo; Rodrigo A Toledo; Luc G T Morris; Ronald A Ghossein; James A Fagin; Timothy A Chan; Victor E Velculescu; Bert Vogelstein; Kenneth W Kinzler; Nickolas Papadopoulos; Barry D Nelkin; Douglas W Ball Journal: J Clin Endocrinol Metab Date: 2012-12-21 Impact factor: 5.958
Authors: Mario E Lacouture; Milan J Anadkat; René-Jean Bensadoun; Jane Bryce; Alexandre Chan; Joel B Epstein; Beth Eaby-Sandy; Barbara A Murphy Journal: Support Care Cancer Date: 2011-06-01 Impact factor: 3.603