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Vorinostat Case Study

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disequilibrium between acetylation and deacetylation leading to apoptosis of the transformed neoplastic cells. In addition, these inhibitors have also been shown in vitro to induce redifferentiation of cancer cells by restoring the function of the sodium–iodine symporter (NIS), and thus, they may restore the iodine uptake by the refractory TCs
[30]. Vorinostat, a small molecule inhibitor of HDAC, has been studied in small phase I and II trials in patients with refractory DTCs; however, the results were clinically disappointing as the RR was 0, 56 % of patients had stable disease for only 6 months, and TG did not correlate with tumor response. Its effect on RAI uptake was not tested in this study [31, 32].
Other drugs
Anti-proliferation …show more content…

In another study including more patients, increases in radioiodine uptake after[6 weeks of pretreatment with up to 8 mg of rosiglitazone were observed in 26 % of the patients. However, post-therapy decreases in TG levels were only noted in
17 % of cases [37]. But it is not clear if this redifferentiation of the tumor will improve the outcome for patients with refractory TCs.
Lithium
The effect of RAI with lithium carbonate was studied in 12 patients with metastatic DTC. Despite an increased uptake of RAI in seven patients, no beneficial effect of RAI with lithium was observed on the clinical course as assessed by
TG measurements and radiographically [38].
Thalidomide
Thalidomide and its derivative lenalidomide were studied in progressive MTC and DTC but without significant effect
[39].
Bortezomib
It (proteasome inhibitor) has been shown to have an effect on the growth in ATC cell lines alone and in combination with other drugs [40].
Combretastatin A4 phosphate (CA4P)
It is a tubulin-binding compound. It is a vascular disrupting agent, resulting in reduced central blood flow to the tumor.
In a phase I study, a single patient with ATC had a durable
CR of more than 9 years with CA4P monotherapy [41].
Preliminary data from a subsequent phase II study in 26
ATC patients failed to obtain any objective responses,

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