Emerging treatments
Tyrosine kinase inhibitors
Chemotherapeutic agents that target RET proto-oncogene signaling pathways are being evaluated in the treatment of medullary thyroid cancer. These agents specifically inhibit growth signals activated by RET proto-oncogene tyrosine kinase activity thought to drive tumor development. Several agents with high affinity for RET proto-oncogene are in clinical trials. Vandetanib showed significant regression of disease in up to one third of patients and disease stabilization in another one half of patients in phase 2 trials.[93] If effective, these would be the first systemic therapies available to treat metastatic medullary thyroid cancer. Adverse effects on thyroid function have been observed with tyrosine kinase inhibitors, and thyroid function tests should be monitored. There is growing interest in, and evidence for, the use of tyrosine kinase inhibitors (e.g., vandetanib and cabozantinib) in the management of radiologically progressive, clinically important metastatic medullary thyroid cancer.[5]
Laparoscopic surgery
Laparoscopic adrenalectomy is associated with reduced postoperative pain, reduced scarring, and a shorter hospital stay when compared with open adrenalectomy.[11] However, open adrenalectomy may be preferred for larger tumors with vascular involvement.
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