Introduction: There are new therapies indicated in medullary thyroid cancer (MTC) based on different molecular targets, that appear to be effective in some cases with advanced disease, although many are still under investigation.
Material and methods: We retrospectively evaluated five cases of medullar thyroid advanced carcinoma that later were referred to Oncology Department for Chemotherapy treatment.
Results: Five patients (mean age 52±18.8 years) were evaluated. All cases were sporadic and stage IV at diagnosis. Four cases had undergone total thyroidectomy and cervical lymphadenectomy. three patients had metastases at diagnosis, the other two patients persistent with local disease after surgery. The average value of calcitonin prior to the oncology evaluation was 3072.6±3789.6 pg/ml (3828600 pg/ml) and CEA 576.5±856.9 ng/ml (13.232075 ng/ml). Threeout of five patient received chemotherapy (Vandetanib). The average decrease in calcitonin and CEA in treated patients was 1350±2448.8 pg/ml (−240 to 4170 pg/ml) and 1862.3±1009.1 (−275 to 1714 ng/ml). None of them showed advanced disease on different imaging studies, and two of them had mild radiological improvement. Two untreated patients had showed a mean increase of calcitonin and CEA of 377 pg/ml and 10.3 ng/ml; in both cases the radiologic stability of the disease remained in time. Only one patient had cutaneous toxicity with Vandetanib.
Conclusions: Patients with Vandetanib had certain laboratory and radiologic improvement, although more investigation of the long-term efficacy would be necessary. In our study, patients with asymptomatic metastatic MTC disease had persisted with radiologic and analytical stability despite not chemotherapy applied. These data are consistent with current recommendations about not to treat patients with these characteristics.