What is the effect of impaired cellular differentiation on NIS (Nodular Iodide Symporter) expression and therapy resistance?

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From the Research

The most effective approach to addressing cellular changes that impair radioiodine therapy effectiveness in thyroid cancer is to use redifferentiation therapy with targeted drugs like CTOM-DHP, a novel tyrosine kinase inhibitor, which can restore NIS expression and function, potentially making previously resistant tumors responsive to radioiodine therapy. This approach is supported by a recent study published in 2020 in the Thyroid journal, which found that CTOM-DHP can augment radioactive iodine uptake through endogenous sodium/iodide symporter expression in anaplastic thyroid cancer 1.

The use of CTOM-DHP has been shown to increase the expression of thyroid-specific proteins and thyroid transcription factors related to iodide metabolism, and to enhance NIS function, demonstrated by an increase in 125I uptake and 131I cytotoxicity 1. The inhibition of PI3K/Akt and MAPK signaling pathways is associated with the increased endogenous NIS expression, which is a key factor in restoring radioiodine avidity in anaplastic thyroid cancer.

Key points to consider when using CTOM-DHP for redifferentiation therapy include:

  • The treatment duration typically continues until radioiodine administration
  • Monitoring for side effects is crucial, although the specific side effects of CTOM-DHP are not well-documented in the available evidence
  • The therapy is particularly valuable for patients with radioiodine-refractory differentiated thyroid cancer where standard treatments have failed
  • The use of CTOM-DHP may offer a promising approach to restoring radioiodine avidity in anaplastic thyroid cancer, although further studies are needed to fully establish its efficacy and safety.

It is worth noting that other studies have investigated the use of different targeted therapies, such as MEK inhibitors and BRAF inhibitors, for redifferentiation therapy in thyroid cancer 2, 3, 4. However, the most recent and highest-quality study available suggests that CTOM-DHP may be a promising option for restoring NIS expression and function in anaplastic thyroid cancer 1.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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