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Report: Treatment Landscape for Thyroid Cancer Will Change Dramatically Through 2021

Several new drugs poised to enter the marketplace (Feb. 4)

Decision Resources, a research and advisory firm located in Burlington, Mass., finds that, through 2021, the treatment landscape for thyroid carcinoma will change dramatically in the U.S. because of the expected approval of several new therapies.

In addition to cabozantinib (Cometriq, Exelixis) — which was approved by the FDA late last year for the treatment of advanced medullary thyroid cancer — the other emerging treatments in the thyroid carcinoma arena are sorafenib (Nexavar, Bayer HealthCare/Onyx Pharmaceuticals); lenvatinib (formerly E7080, Eisai); vemurafenib (Zelboraf , Genentech/Roche); the combination of dabrafenib and trametinib (GlaxoSmithKline); and fosbretabulin (Zybrestat, OXiGENE). A major focus of drug development has been on patients with radioiodine (RAI)-refractory, differentiated thyroid cancer (DTC).

“These therapies will likely be high-priced but will dramatically increase treatment options for RAI-refractory thyroid carcinoma patient populations, for which there is no standard of care,” said analyst Gemma McConnell, PhD.

According to the new report, the overall incidence of thyroid cancer will increase over the next decade, driven by demographic changes and more sensitive diagnostic procedures. In particular, the incidence of papillary thyroid cancer (PTC), which accounts for most of the diagnosed cases of thyroid cancer, will increase. The report predicts that, in 2021, the number of incident cases of PTC will grow by approximately 23%, thereby contributing to an increase in the size of the drug-treatable population.

The report also finds that the opportunity for uptake of emerging agents developed for DTC will be constrained by small patient populations in the locally advanced or advanced disease setting. Most cases of DTC are usually diagnosed early and have a good prognosis with surgery — typically a total thyroidectomy — and RAI ablation therapy.

“Surgery and RAI therapy is the primary treatment approach for patients whose disease is considered resectable, and the tumor is RAI-avid,” McConnell said. “As long as a patient remains RAI-avid, RAI will remain the treatment of choice, constraining the opportunity for emerging therapies.”

Source: Decision Resources; February 4, 2013.

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