Despite the fact that most patients with DTC had received large doses of radioiodine and some had received external beam radiation therapy, both of which have myelosuppressive potential, treatment with sunitinib was well tolerated in most patients with DTC as well as in the patients with MTC. These results are encouraging, but, as our series was small and did not evaluate efficacy, more extensive studies in DTC and MTC are needed to determine the possible roles of sunitinib in these very different tumors.

Tyrosine kinase receptors have been implicated in thyroid cancer. Therefore, tyrosine kinase inhibitors may be used for the treatment of advanced metastatic thyroid carcinoma. The aim is to present a case of metastatic papillary thyroid carcinoma responding to the administration of sunitinib, a multi-targeted protein kinase inhibitor. A patient presented with metastatic papillary thyroid carcinoma and hyperthyroidism. After euthyroidism was achieved the patient was treated by the administration of therapeutic radioiodine (131)I, radiotherapy and sunitinib, a multi-targeted tyrosine kinase inhibitor. Thyroglobulin levels decreased from 9,594 to 6,816 ng/ml after 1 month, 6 months later being 2,776 ng/ml. The lesion in the pelvis was 12.5 × 9 cm before treatment decreasing thereafter and the patient improved clinically. The administration of sunitinib resulted in partial disease response in a patient with progressive metastatic papillary thyroid carcinoma. Protein kinase inhibitors may prove useful in the management of advanced metastatic papillary thyroid carcinoma.

Metabolic syndrome, a clustering of risk factors including obesity, has emerged as a global health plague. A lot of epidemiological and clinical evidence suggests that the metabolic syndrome is linked not only to cardiovascular diseases and diabetes mellitus type 2 but also to cancer development and progression. In this review the potential mechanisms tying the metabolic syndrome with cancer are presented. The role of insulin resistance and hyperinsulinemia, the activation of insulin-like growth factor-1 (IGF-1) pathway, and the induction of cytotoxic products are highlighted. Subsequent effects leading to oxidative stress, release of lipokines with signaling properties by adipocytes, development of a sustained systemic inflammation, production of inflammatory cytokines, and establishment of a tumorigenic environment are also discussed. The importance of the metabolic syndrome and obesity coupled with the deeper understanding of the underlying molecular mechanisms has trigger intensive clinical research with an aim to prevent the risk of cancer and improve outcomes. Moreover, the need for lifestyle changes with increased physical activity and improved dietary quality has been emerged as urgent health priority.

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