Thyroid Cancer (Thyroid Carcinoma): Drug Therapy

Therapeutic targets

  • Improvement of the symptomatology
  • Elimination of tumor cells
  • Establishment of a euthyroid metabolic state (normal thyroid function).

Therapy recommendations

  • Depending on the histology of the tumor, resection (removal) of the equilateral thyroid lobe or total thyroidectomy (thyroidectomy) with lymph node extirpation (lymph node removal) (see “Surgical Therapy” below), radioiodine therapy, radiation therapy (see “Radiation Therapy” below), or/and cytostatic therapy (see below).
  • After surgical thyroidectomy should be followed by radioiodine therapy in follicular and papillary thyroid carcinoma and metastases (daughter tumors) in the aftercare
  • Thyroidectomy/radioiodine therapy must be followed by lifelong intake of thyroid hormones (L-thyroxine preparations). Note: Strict TSH-suppressive therapy is now only required in persistent tumor disease.
  • In medullary thyroid carcinoma, therapy with tyrosine kinase inhibitors (cabozantinib, vandetanib) can be performed, if necessary, after total thyroidectomy with lymph node extirpation (Note: The tumor is not radiosensitive) in advanced stages.
  • In anaplastic thyroid carcinoma (ATC), patients benefit from multimodality therapy.
  • Treatment of advanced radiorefractory thyroid carcinoma (approximately 5-15% of those affected) as well as for patients with medullary thyroid carcinoma (see above. ): tyrosine kinase inhibitors (cabozantinib, lenvatinib (preferred; effective for patients with metastatic radioiodine refractory DTC (RR-DTC), nintedanib (tyrosine kinase inhibitor and angiokinase inhibitor: second-line therapy of RR-DTC patients) sorafenib, sunitinib, vandetanib); significantly prolong progression-free survival by 6 to 14 months.
  • See also under “Other therapy.”

No dosages of cytostatic drugs (substances that inhibit cell growth or cell division, respectively) are given below, as therapy regimens are constantly modified.

Cytostatics