Dr. Cohen Discusses Treating Medullary Thyroid Cancer

Ezra Cohen, MD, Associate Professor of Medicine, University of Chicago, discusses treating patients with medullary thyroid cancer (MTC) who do not have an available curative option and have progressive disease in need of therapeutic intervention.

Cohen believes that it is important to first assess the pace of progression for patients with MTC, before making a treatment decision. Determining the rate of progression, lesions, symptoms, and metastasis will help guide the therapy that is administered.

Cohen's first choice for progressive patients would be the multikinase inhibitor cabozantinib (XL184), if the FDA approves it. He believes the data from the phase III EXAM trial demonstrated a very strong response to this agent. Patients on the trial represented an aggressive and refractory population that experienced an 11.2-month increase in progression-free survival, compared to only 4 months in the placebo arm (HR 0.28, 95% CI 0.19-0.40, P < 0.0001).

Other tyrosine kinase inhibitors have not achieved this degree of response for patients with MTC, in the past. As a result, Cohen describes these findings as very impressive.