难治性甲状腺癌药物治疗新技术和新方法的研究进展  

Research progress on advanced therapeutic approaches and emerging technologies in the drug treatment of refractory thyroid cancer

作　　者：陈虹丹 黄银德 李翀[2] CHEN Hongdan;HUANG Yinde;LI Chong(Department of Breast and Thyroid Surgery,Chongqing General Hospital,Chongqing University,Chongqing 401147,China;College of Pharmaceutical Sciences,Southwest University,Chongqing 400715,China)

机构地区：[1]重庆大学附属人民医院,重庆市人民医院乳腺甲状腺外科,重庆401147 [2]西南大学药学院,重庆400715

出　　处：《中国临床药理学与治疗学》2025年第3期325-331,共7页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：重庆市渝中区自然科学基金(No.20240128);重庆市卫生健康委医学科研项目(No.2025WSJK052)。

摘　　要：分化程度较差的甲状腺癌及晚期甲状腺癌因恶性程度高、进展快且对放化疗不敏感,治疗手段有限,成为目前甲状腺癌治疗中的难点问题。通过对甲状腺癌致癌机制的研究,多种激酶抑制剂被用于难治性甲状腺癌,比如达拉非尼(BRAF抑制剂)、曲美替尼(MEK抑制剂)、仑伐替尼(RET抑制剂)、乐伐替尼(VEGF抑制剂)以及多靶点激酶抑制剂。然而,药物耐药不可避免,极大地限制了激酶抑制剂的应用。免疫治疗、甲状腺癌的再分化策略、放射性核素偶联药物等治疗手段以及纳米技术在治疗中的应用目前仍处于临床研究阶段,亟需进一步明确其疗效。全面了解难治性甲状腺癌的治疗策略及可选择的治疗组合在甲状腺癌诊疗中具有极其重要的意义。因此,本文从化疗,分子靶向治疗、免疫治疗、放射性核素治疗等方面对难治性甲状腺癌治疗新技术和新方法进行综述,以期能为难治性甲状腺癌治疗策略的选择提供参考。Poorly differentiated and advanced thyroid cancers are characterized by high malignancy,progress rapidly,and resistance to radiotherapy and chemotherapy.These characteristics pose significant challenges,severely limiting effective treatment options.Various kinase inhibitors have been used in the treatment of refractory thyroid cancer were used accompanying by the carcinogenic mechanisms'studies investigating in thyroid cancer,such as Dabrafenib(BRAF inhibitor),Trametinib(MEK inhibitor),Vandetanib(RET inhibitor),Lenvatinib(VEGF inhibitor),and multi-target kinase inhibitors.However,drug resistance remains an inevitable issue,significantly limiting the efficacy and application of kinase inhibitors.Therapeutic approaches such as immunotherapy,redifferentiation strategies for thyroid cancer,radiopharmaceutical conjugates,and the application of nanotechnology are currently in the clinical research stage,requiring further clarification of their efficacy.Comprehensive understanding of therapeutic strategies and available treatment combinations for refractory thyroid cancer is of paramount importance in the diagnosis and treatment of thyroid cancer.Therefore,this article reviews technologies and methods for treating refractory thyroid cancer,focusing on chemotherapy,molecular targeted therapy,immunotherapy,and radiopharmaceutical therapy,aiming to provide a reference for selecting treatment strategies for refractory thyroid cancer.

关 键 词：难治性甲状腺癌 分子靶向治疗 免疫治疗 放射性核素治疗 纳米技术 

分 类 号：R736[医药卫生—肿瘤]