Эффективность вандетаниба в лечении медуллярного рака щитовидной железы: обзор литературы и клинический случай

Медуллярный рак щитовидной железы (МРЩЖ) – редкое заболевание, на долю которого приходится 1,7 % всех случаев злокачественных опухолей щитовидной железы. Как правило, МРЩЖ выявляют на ранних стадиях, однако у 10–15 % пациентов опухоль впервые обнаруживают на стадии местно-распространенных форм и отдаленных метастазов. Лечение данной категории пациентов представляет собой сложную задачу из-за биологических особенностей заболевания и небольшого количества эффективных методов. Однако изучение механизмов развития опухоли и развитие современной фармакологии привели к разработке новой группы таргетных препаратов – ингибиторов тирозинкиназ, эффективность которых в лечении нерезектабельного прогрессирующего местно-распространенного или метастатического МРЩЖ продемонстрирована в различных клинических исследованиях. В Российской Федерации для лечения МРЩЖ зарегистрирован и доступен вандетаниб. Ввиду редкости МРЩЖ каждый новый клинический случай применения вандетаниба для его лечения крайне интересен. Более того, с момента одобрения препарата в 2011 г. в США Управление по санитарному надзору за качеством пищевых продуктов и медикаментов (FDA) накопило новые данные о клиническом использовании вандетаниба. Важно, что клинические исследования, как правило, характеризуются хорошо продуманным дизайном и практически идеальными условиями, в то время как в реальной клинической практике условия могут различаться, а пациенты могут обладать индивидуальными особенностями. В связи с этим целью публикации стало обновление информации об эффективности и безопасности вандетаниба, в том числе с учетом ретроспективного анализа научной литературы, имеющейся в медицинских базах, а также описание случая применения вандетаниба в клинической практике.

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