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ATA updates treatment guidelines for medullary thyroid carcinoma
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The American Thyroid Association released updated guidelines for the diagnosis and treatment of medullary thyroid carcinoma, in the first revision of the original guidelines since 2009.
The ATA appointed a task force of experts, who presented their recommendations in an article appearing in the journal Thyroid.
“Despite significant advances in the diagnosis and treatment of patients with [medullary thyroid carcinoma], much remains to be done,” the researchers wrote. “In patients with advanced [medullary thyroid carcinoma], there is a critical need for more effective therapies.”
Task force chair Samuel A. Wells Jr., MD, of the National Cancer Institute at the NIH in Bethesda, Maryland, and colleagues reviewed the basic science and clinical literature and developed evidence-based recommendations to guide physicians in the diagnosis and treatment of patients with sporadic and hereditary medullary thyroid carcinoma (MTC). The 67 recommendations represent current and optimal medical practice.
“The ATA recommended that the guidelines for the management of patients with MTC be updated because recent significant advances in clinical research, especially the results of clinical trials, improved methods in the diagnosis and treatment of patients with MTC, and the need to consider a new classification for the multiple endocrine neoplasia type 2 syndromes,” Wells told Endocrine Today. “These revisions are reflected in new recommendations in the document.”
Recommended changes include revising ATA risk categories, citing “confusion” with the current names. Category D should be changed to “highest risk,” category C should be changed to “high risk” and categories A and B combined into the new category “moderate risk,” according to the new guidelines.
The guidelines also recommend that multiple endocrine neoplasia 2 (MEN2) become two distinct syndromes: MEN2A (with 4 variants) and MEN2B, which is more rare.
Although patients with advanced disease experience reduction in tumor size and have significantly prolonged progression-free-survival with therapeutic compounds, drug resistance almost always develops and the tumor progresses. There is a critical need for more effective drugs, or combinations of drugs, that will improve the overall survival of these patients, according to researchers.
“The updated MTC guidelines provide a superb overview on the biology, diagnosis and therapy of MTC,” Peter A. Kopp, MD, editor-in-chief of Thyroid and associate professor at Northwestern University Feinberg School of Medicine, said in a press release. “They form a state-of-the-art basis for a differentiated clinical care of patients with MTC and also highlight areas that are in need of further investigation and improvements.” – by Regina Schaffer
Disclosure: Wells reports no relevant financial disclosures. Please see the full study for a full list of all other authors’ relevant financial disclosures.
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