Skip to main content
Top
Published in:

12-06-2024 | Thyroid Cancer

Promising Therapeutic Targets for Recurrent/Metastatic Anaplastic Thyroid Cancer

Authors: Abdelrahman Sherif Abdalla, MD, Mobeen Rahman, MD, Saad A. Khan, MD

Published in: Current Treatment Options in Oncology | Issue 7/2024

Login to get access

Opinion statement

Anaplastic thyroid cancer presents formidable challenges, particularly in cases of recurrence or metastasis. Timely BRAF V600E testing is imperative at diagnosis, initially through immunohistochemistry, followed by comprehensive genomic profiling encompassing genes such as NTRK, RET, ALK, and assessment of tumor mutation burden (TMB). FDA-approved treatment options include dabrafenib and trametinib for patients with BRAF mutations, while those exhibiting high TMB may benefit from pembrolizumab. Further therapeutic decisions hinge upon mutational profile, urgency of response required, airway integrity, and access to targeted therapies There is growing use of immunotherapy for ATC based on published reports of activity, but currently there is no FDA approved agent for ATC. The off-label utilization of “precision medicine” combinations imposes a considerable financial strain, underscoring the necessity for further clinical trials to elucidate promising therapeutic avenues for this orphan disease. There is a pressing need for the development and support of clinical trials investigating genomically driven and immune-based therapies for anaplastic thyroid cancer.
Literature
2.
go back to reference Lin B, Ma H, Ma M, et al. The incidence and survival analysis for anaplastic thyroid cancer: a SEER database analysis. Am J Transl Res. 2019;11(9):5888–96.PubMedPubMedCentral Lin B, Ma H, Ma M, et al. The incidence and survival analysis for anaplastic thyroid cancer: a SEER database analysis. Am J Transl Res. 2019;11(9):5888–96.PubMedPubMedCentral
6.
go back to reference Skwiersky S, Hevroni G, Singh G, et al. Concurrent anaplastic and papillary thyroid carcinomas: a case report. Am J Med Case Rep. 2020;8(7):202–5.CrossRef Skwiersky S, Hevroni G, Singh G, et al. Concurrent anaplastic and papillary thyroid carcinomas: a case report. Am J Med Case Rep. 2020;8(7):202–5.CrossRef
8.
go back to reference Khairy G. Anaplastic transformation of differentiated thyroid carcinoma. Int J Health Sci. 2009;3(1):93–6. Khairy G. Anaplastic transformation of differentiated thyroid carcinoma. Int J Health Sci. 2009;3(1):93–6.
13.
go back to reference • Sherman EJ, Harris J, Bible KC, et al. Radiotherapy and paclitaxel plus pazopanib or placebo in anaplastic thyroid cancer (NRG/RTOG 0912): a randomised, double-blind, placebo-controlled, multicentre, phase 2 trial. Lancet Oncol. 2023;24(2):175–86. https://doi.org/10.1016/S1470-2045(22)00763-X. This reference is of importance as this is the largest clinical trial for anaplastic thyroid cancer which explored the addition of pazopanib to the combination of paclitaxel and radiotherapy. Although it showed pazopanib to be a safe addition to the combination, there is no statistically significant improvement of survival in the intervention group versus placebo.CrossRefPubMedPubMedCentral • Sherman EJ, Harris J, Bible KC, et al. Radiotherapy and paclitaxel plus pazopanib or placebo in anaplastic thyroid cancer (NRG/RTOG 0912): a randomised, double-blind, placebo-controlled, multicentre, phase 2 trial. Lancet Oncol. 2023;24(2):175–86. https://​doi.​org/​10.​1016/​S1470-2045(22)00763-X. This reference is of importance as this is the largest clinical trial for anaplastic thyroid cancer which explored the addition of pazopanib to the combination of paclitaxel and radiotherapy. Although it showed pazopanib to be a safe addition to the combination, there is no statistically significant improvement of survival in the intervention group versus placebo.CrossRefPubMedPubMedCentral
22.
go back to reference Wallin G, Bäckdahl M, Tallroth-Ekman E, Lundell G, Auer G, Löwhagen T. Co-existent anaplastic and well differentiated thyroid carcinomas: a nuclear DNA study. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 1989;15(1):43–8. Wallin G, Bäckdahl M, Tallroth-Ekman E, Lundell G, Auer G, Löwhagen T. Co-existent anaplastic and well differentiated thyroid carcinomas: a nuclear DNA study. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 1989;15(1):43–8.
32.
go back to reference •• Khan SA. Phase II trial of pembrolizumab in metastatic or locally advanced anaplastic/ undifferentiated thyroid cancer. clinicaltrials.gov; 2022. Accessed 31 Dec. 2022. https://clinicaltrials.gov/study/NCT02688608. This reference is of outstanding importance as it is a comprehensive genomic profiling of 90 ATC specimens. It showed that clinically relevant genomic alteration in ATC specimens varies by patient age which provides insight into individualized medicine for targeted therapy in ATC patients. •• Khan SA. Phase II trial of pembrolizumab in metastatic or locally advanced anaplastic/ undifferentiated thyroid cancer. clinicaltrials.​gov; 2022. Accessed 31 Dec. 2022. https://​clinicaltrials.​gov/​study/​NCT02688608. This reference is of outstanding importance as it is a comprehensive genomic profiling of 90 ATC specimens. It showed that clinically relevant genomic alteration in ATC specimens varies by patient age which provides insight into individualized medicine for targeted therapy in ATC patients.
Metadata
Title
Promising Therapeutic Targets for Recurrent/Metastatic Anaplastic Thyroid Cancer
Authors
Abdelrahman Sherif Abdalla, MD
Mobeen Rahman, MD
Saad A. Khan, MD
Publication date
12-06-2024
Publisher
Springer US
Published in
Current Treatment Options in Oncology / Issue 7/2024
Print ISSN: 1527-2729
Electronic ISSN: 1534-6277
DOI
https://doi.org/10.1007/s11864-024-01219-y

Other articles of this Issue 7/2024

Current Treatment Options in Oncology 7/2024 Go to the issue