scholarly journals Anaplastic thyroid cancer – an overview of genetic variations and treatment modalities

2015 ◽  
pp. 43 ◽  
Author(s):  
Honey Reddi ◽  
Anirudh Kumar ◽  
Roger Kulstad
Keyword(s):  
Thyroid Cancer ◽  
Anaplastic Thyroid Cancer ◽  
Genetic Variations ◽  
Treatment Modalities

scholarly journals An Update of the Appropriate Treatment Strategies in Anaplastic Thyroid Cancer: A Population-Based Study of 735 Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Nai-si Huang ◽  
Xiao Shi ◽  
Bo-wen Lei ◽  
Wen-jun Wei ◽  
Zhong-wu Lu ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Distant Metastasis ◽  
Cox Regression ◽  
Early Stage ◽  
Locally Advanced ◽  
Treatment Strategies ◽  
Anaplastic Thyroid Cancer ◽  
Treatment Modalities ◽  
Cox Regression Analysis ◽  
Adjacent Structures

Background. Anaplastic thyroid cancer (ATC) responds poorly to conventional therapies and requires a multidisciplinary approach to manage. The aim of the current study is to explore whether aggressive treatment is beneficial, especially the appropriate extent of surgery in ATC. Methods. Patients diagnosed with ATC from 2004 to 2014 were identified from the Surveillance, Epidemiology, and End Results (SEER) database and included in our study. Results. A total of 735 ATC patients were identified. The two-year overall survival (OS) rates for stage IVA, IVB, and IVC patients were 36.5%, 15.6%, and 1.4%, respectively. By directly comparing eight treatment modalities, we found that surgery+radiotherapy RT±chemotherapy was the most effective treatment strategy. surgery+chemotherapy and RT+chemotherapy had comparable results (hazard ratio HR=1.461, 95% confidential interval (CI): 0.843-2.531, P=0.177). Multivariate Cox regression analysis also showed increased mortality risk in patients with increased age (HR=1.022, P<0.001), tumor extension to adjacent structures (HR=1.649, P=0.013), and distant metastasis (HR=2.041, P<0.001), while surgery+RT (HR=0.600, P=0.004) and chemotherapy (HR=0.692, P=0.010) were independently associated with improved OS. Further analysis revealed that patients undergoing total/near-total thyroidectomy (TT) had superior OS to those receiving less than TT (P<0.001). In subgroup analysis, the benefit of TT remained significant in patients with tumors larger than 4.0 cm (HR=0.776, 95% CI: 0.469-0.887, P=0.007), with adjacent structure extension (HR=0.642, 95% CI: 0.472-0.877, P=0.005), including trachea and major vessels, but not in patients with early phase local disease such as tumor≤4.0 cm or tumor within the thyroid or with minimal extrathyroidal extension. Patients with very locally advanced disease or distant metastasis could not benefit from TT as well. Conclusions. In operable cases, surgery+RT±chemotherapy was the optimal treatment modality. Otherwise, RT+chemotherapy was the appropriate strategy. However, TT was not beneficial for very early stage or metastatic ATC.

scholarly journals Updates on the Management of Thyroid Cancer

2020 ◽  
Vol 52 (08) ◽  
pp. 562-577 ◽  
Author(s):  
Katherine A. Araque ◽  
Sriram Gubbi ◽  
Joanna Klubo-Gwiezdzinska
Keyword(s):  
Thyroid Cancer ◽  
Kinase Inhibitors ◽  
Treatment Options ◽  
Anaplastic Thyroid Cancer ◽  
Braf V600e ◽  
Treatment Modalities ◽  
American Thyroid Association ◽  
Novel Treatment ◽  
High Risk Disease ◽  
Diagnostic Modalities

AbstractThe diagnostic modalities, stratification tools, and treatment options for patients with thyroid cancer have rapidly evolved since the development of the American Thyroid Association (ATA) guidelines in 2015. This review compiles newer concepts in diagnosis, stratification tools and treatment options for patients with differentiated thyroid cancer (DTC), medullary thyroid carcinoma (MTC) and anaplastic thyroid cancer (ATC). Newer developments apply precision medicine in thyroid cancer patients to avoid over-treatment in low risk disease and under-treatment in high risk disease. Among novel patient-tailored therapies are selective RET inhibitors that have shown efficacy in the treatment of MTC with limited systemic toxicity compared with non-specific tyrosine kinase inhibitors. The combination of BRAF and MEK inhibitors have revolutionized management of BRAF V600E mutant ATC. Several immunotherapeutic agents are being actively investigated in the treatment of all forms of thyroid cancer. In this review, we describe the recent advances in the diagnosis and management of DTC, MTC, and ATC, with an emphasis on novel treatment modalities.

Clinical Outcomes of Different Treatment Modalities in Anaplastic Thyroid Cancer

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Mohammed Al-Jumayli ◽  
Hameem I. Kawsar ◽  
Prakash Neupane
Keyword(s):  
Thyroid Cancer ◽  
Clinical Outcomes ◽  
Anaplastic Thyroid Cancer ◽  
Treatment Modalities

scholarly journals Treatment Outcomes in Anaplastic Thyroid Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Kelsey L. Corrigan ◽  
Hannah Williamson ◽  
Danielle Elliott Range ◽  
Donna Niedzwiecki ◽  
David M. Brizel ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Surgical Resection ◽  
External Beam Radiotherapy ◽  
Performance Status ◽  
Anaplastic Thyroid Cancer ◽  
Disease Recurrence ◽  
Median Number ◽  
Treatment Modalities ◽  
New Therapeutic Approaches ◽  
Thyroid Malignancies

Background. Anaplastic thyroid cancer (ATC) is rare, accounting for 1-2% of thyroid malignancies. Median survival is only 3-10 months, and the optimal therapeutic approach has not been established. This study aimed to evaluate outcomes in ATC based on treatment modality. Methods. Retrospective review was performed for patients treated at a single institution between 1990 and 2015. Demographic and clinical covariates were extracted from the medical record. Overall survival (OS) was modeled using Kaplan Meier curves for different treatment modalities. Univariate and multivariate analyses were conducted to assess the relationships between treatment and disease characteristics and OS. Results. 28 patients with ATC were identified (n = 16 female, n = 12 male; n = 22 Caucasian, n = 6 African-American; median age 70.9). Majority presented as Stage IVB (71.4%). Most patients received multimodality therapy. 19 patients underwent local surgical resection. 21 patients received locoregional external beam radiotherapy (EBRT) with a median cumulative dose of 3,000 cGy and median number of fractions of 16. 14 patients received systemic therapy (n = 11 concurrent with EBRT), most commonly doxorubicin (n = 9). 16 patients were never disease free, 11 patients had disease recurrence, and 1 patient had no evidence of disease progression. Median OS was 4 months with 1-year survival of 17.9%. Regression analysis showed that EBRT (HR: 0.174; 95% CI: 0.050–0.613; p=0.007) and surgical resection (HR: 0.198; 95% CI: 0.065–0.598; p=0.004) were associated with improved OS. Administration of chemotherapy was not associated with OS. Conclusions. Anaplastic thyroid cancer patients receiving EBRT to the thyroid area/neck and/or surgical resection had better OS than patients without these therapies, though selection bias likely contributed to improved outcomes since patients who can undergo these therapies tend to have better performance status. Prognosis remains poor overall, and new therapeutic approaches are needed to improve outcomes.

scholarly journals The Role of ATP-Binding Cassette Transporters in the Chemoresistance of Anaplastic Thyroid Cancer: A Systematic Review

Endocrinology ◽  
2019 ◽  
Vol 160 (8) ◽  
pp. 2015-2023 ◽  
Author(s):  
Elnaz Abbasifarid ◽  
Sayed Mahmoud Sajjadi-Jazi ◽  
Maryam Beheshtian ◽  
Hilda Samimi ◽  
Bagher Larijani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Thyroid Cancer ◽  
Abc Transporters ◽  
Anaplastic Thyroid Cancer ◽  
Treatment Modalities ◽  
Cochrane Library ◽  
Atp Binding ◽  
Resistance To Chemotherapy ◽  
Atp Binding Cassette

AbstractAnaplastic thyroid cancer (ATC) is an aggressive type of thyroid cancer with a high mortality rate. Cytotoxic drugs are among the treatment modalities usually used for ATC treatment. However, systemic chemotherapies for ATC have not been shown to have remarkable efficacy. ATP-binding cassette (ABC) transporters have been suggested as a possible mechanism in ATC resistance to chemotherapy. This systematic review was aimed to define the possible roles of ABC transporters in ATC resistance to chemotherapy. Numerous databases, including Scopus, Web of Science, PubMed, Cochrane Library, Ovid, ProQuest, and EBSCO, were searched for papers published since 1990, with predefined keywords. The literature searches were updated twice, in 2015 and 2017. All identified articles were reviewed, and 14 papers that met the inclusion criteria were selected. In the eligible studies, the roles of 10 out of 49 ABC transporters were evaluated; among them, three pumps (ABCB1, ABCC1, and ABCG2) were the most studied transporters in ATC samples. ABCC1 and ABCG2 had the highest expression rates in ATC, and ABCB1 ranked second among the inspected transporters. In conclusion, ABC transporters are the major determinants of ATC resistance to chemotherapy. By identifying these transporters, we can tailor the best treatment approach for patients with ATC. Additional studies are needed to define the exact role of each ABC transporter and other mechanisms in ATC drug resistance.

scholarly journals Anaplastic Thyroid Cancer: The Addition of Systemic Chemotherapy to Radiotherapy Led to an Observed Improvement in Survival—A Single Centre Experience and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Natalie M. Lowe ◽  
Sean Loughran ◽  
Nicholas J. Slevin ◽  
Beng K. Yap
Keyword(s):  
Thyroid Cancer ◽  
Median Survival ◽  
Palliative Radiotherapy ◽  
Multimodality Treatment ◽  
Anaplastic Thyroid Cancer ◽  
Anaplastic Thyroid Carcinoma ◽  
Treatment Modalities ◽  
Previous Surgery ◽  
Poor Outcomes ◽  
Oncology Centre

Introduction. Anaplastic thyroid carcinoma (ATC) is rare yet accounts for up to 50% of all thyroid cancer deaths. This study reviews outcomes of patients with confirmed ATC referred to a tertiary oncology centre plus reviews the literature to explore how poor outcomes may be improved.Materials and Methods. The management and outcomes of 20 patients with ATC were reviewed.Results. Median age at diagnosis was 69.5 years. 19 patients died due to ATC, 40% of whom died from asphyxiation. Median survival for all cases was 59 days. Patients who had previous surgery prior to other treatment modalities had a longer median survival overall compared to those who had not had previous surgery (142 days compared to 59 days) and produced the one long-term survivor. Chemotherapy followed by radiotherapy (without previous surgery) was associated with longer median survival (220 days). Palliative radiotherapy alone did not decrease the rate of death by asphyxiation when compared to other single modality treatments.Conclusion. Multimodality treatment including surgery when feasible remains the best strategy to improve survival and prevent death from asphyxiation in the management of ATC. The addition of chemotherapy to our institutional protocol led to improved survival but prognosis remains very poor.

scholarly journals Potentiated anti-tumor effects of BETi by MEKi in anaplastic thyroid cancer

2019 ◽  
Vol 26 (9) ◽  
pp. 739-750 ◽  
Author(s):  
Xuguang Zhu ◽  
Sunmi Park ◽  
Woo Kyung Lee ◽  
Sheue-yann Cheng
Keyword(s):  
Thyroid Cancer ◽  
Cultured Cells ◽  
Treatment Options ◽  
Combined Treatment ◽  
Anaplastic Thyroid Cancer ◽  
Mek Inhibitor ◽  
Epigenetic Modifications ◽  
Treatment Modalities ◽  
Inhibition Of Proliferation ◽  
Novel Treatment

Anaplastic thyroid cancer (ATC) is an aggressive malignancy with limited treatment options. We explored novel treatment modalities by targeting epigenetic modifications using inhibitors of BET (e.g. BRD4) activity. We evaluated the efficacy in the treatment of ATC of a novel BET inhibitor, PLX51107 (PLX), currently in clinical trials for other solid tumors and hematologic malignancies, alone or combined with a MEK inhibitor, PD0325901(PD). To elucidate the effects of these inhibitors on growth of ATC, we treated ATC cells derived from patient tumors (THJ-11T and THJ-16T cells) and mouse xenograft tumors with inhibitors. We found PLX and PD inhibitors singly inhibited proliferation of both human ATC cells lines, but together exhibited stronger inhibition of proliferation. In mouse xenografts, the combination treatment almost totally blocked growth in xenograft tumors derived from both ATC cells. PD effectively attenuated MEK-ERK signaling, which was further enhanced by PLX in the combined treatment in cultured cells and tumors. Importantly, the combination of PLX and PD acted synergistically to suppress MYC transcription to increase p27 in decreasing tumor cell proliferation. PLX and PD cooperated to upregulate pro-apoptotic proteins to promote apoptosis. These two inhibitors converged to reduce the binding of BRD4 to the MYC promoter to suppress the MYC expression. These findings indicate that combined treatment of BET and MEK-ERK inhibitors was more effective to treat ATC than single targeted treatment. Synergistic suppression of MYC transcription via collaborative actions on chromatin modifications suggested that targeting epigenetic modifications could provide novel treatment opportunities for ATC.

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