Motesanib diphosphate in progressive differentiated thyroid cancer
Sherman et al. (July 3 issue)1 highlight the importance of selecting patients for alternative therapies, such as motesanib diphosphate, in the treatment of progressive differentiated thyroid carcinomas. Although radiographic indings are useful criteria for predicting a response to motesanib, they can be supplemented by the microscopical findings — in particular, growth pattern, necrosis, and desmoplastic reaction — which have been correlated with progression prediction.2 The genotypic alterations described in follicular-cell neoplasms control the mitogen-activated protein (MAP) kinase pathway and proliferation. Was any correlation found with proliferation markers? Which radiographic criteria were used to define progression in metastatic neoplasms? As for tumor progression, it normally refers to the acquisition of invasive capabilities in intraepithelial lesions or metastatic potential in invasive cancers.3
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