Dramatic clinical response to dabrafenib plus trametinib in anaplastic thyroid carcinoma and the challenges faced during the COVID-19 pandemic

Bueno, Fernanda; Abelleira, Erika; Stecher, Florencia Von; Lima, Andrea Paes de; Pitoia, Fabián

doi:10.20945/2359-3997000000325

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…The initial data reported for this ROAR ATC cohort (n = 16) [30] were the first clinical trial results demonstrating the promise of a BRAF plus MEK inhibitor regimen in the treatment of BRAF V600E-mutant ATC, subsequently leading to FDA approval of dabrafenib plus trametinib for this indication [6,25]. Numerous retrospective studies and case reports of antitumor activity and clinical responses with dabrafenib plus trametinib in BRAF V600Emutant ATC join these findings in providing further support for this approach to treatment [44][45][46][47][48][49][50]. While the present analysis confirms and extends the previous results from the ROAR ATC cohort, some limitations remain.…”

Section: Discussionmentioning

confidence: 98%

Dabrafenib plus trametinib in patients with BRAF V600E-mutant anaplastic thyroid cancer: updated analysis from the phase II ROAR basket study

et al. 2022

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Section: Discussionmentioning

confidence: 98%

Dabrafenib plus trametinib in patients with BRAF V600E-mutant anaplastic thyroid cancer: updated analysis from the phase II ROAR basket study

et al. 2022

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“…Angiotensin-converting enzyme 2 and transmembrane protease serine 2 are significantly expressed in the thyroid, making it vulnerable to virus attacks. Since ribonucleic acid (RNA) from COVID-19 was found in the thyroid, this finding strongly suggests that COVID-19 can infect the thyroid and might be able to alter its genomic material [ 37 , 38 , 39 , 40 , 41 ]. Nevertheless, thyroid cancer following COVID-19 illness has received increasing research interest, since the thyroid is an endocrine organ that the immune system can damage.…”

Section: Discussionmentioning

confidence: 99%

Papillary Thyroid Cancer Trends in the Wake of the COVID-19 Pandemic: Is There a Shift toward a More Aggressive Entity?

Hassan,

Bacha

et al. 2024

Diseases

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Background: Globally, the incidence of papillary thyroid cancer (PTC) has been increasing over the last few decades and it has become the second most common cancer in women in the UAE. There is some evidence to suggest that COVID-19 infection might be directly linked to the development of aggressive variants of PTC. The primary goal of this study was to compare the clinical and pathologic characteristics of thyroid cancer patients treated at the largest endocrine surgery center in Abu Dhabi before and after the COVID-19 pandemic outbreak. Methods: This retrospective cohort analysis included patients who underwent elective thyroid surgery at Burjeel Hospital between January 2018 and December 2022. Patients were divided into two groups based on when the COVID-19 outbreak started: group one, comprising patients who had surgery between January 2018 and December 2019 (the “pre-pandemic group”), and group two, comprising patients who had surgery between January 2021 and December 2022 (the “post-pandemic group”). In addition to demographic data, clinicopathological factors, such as aggressive cell type, multifocality, tumor size and location, laterality, lympho-vascular invasion, and extrathyroidal extension, were assessed. We utilized the t-paired test for parametric variables and the Chi-square test for the cross-table analysis. Results: During the study, 1141 people had thyroid surgery, with an annual average of 285 procedures. PTC cases recorded in the final histopathological samples rose from 111 in the pre-pandemic era to 182 in the post-pandemic era. Neither the female-to-male gender ratio, which was 90:21 in the pre-pandemic group and 142:40 in the post-pandemic group (p = 0.532), nor the median age, which was 39.1 and 40.1 years, respectively, varied significantly between the two groups. However, there was a significant increase between pre-pandemic and post-pandemic in the aggressive PTC variants (3% vs. 11.5%, p = 0.001), increased poor prognostic factors such as bilateral multifocality (10.8% vs. 32.4%, p = 0.000), as well as increased capsule–vascular tumor invasion (19.8% vs. 27%); on the other hand, the size of the single foci was 17 mm in the pre-pandemic group compared to 13 mm in the post-pandemic group (p = 0.001). Conclusions: A significant rise in unfavorable prognostic markers and aggressive subtypes of PTC was seen post-pandemic in thyroidectomy patients operated on at a leading endocrine surgery center in the United Arab Emirates.

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“…In our setting, where access to molecular tests and target therapies is not widely available yet, we have reported the cases of two patients with metastatic and locally unresectable ATC, in whom the use of dabrafenib-trametinib (D-T) provided a dramatic reduction of the cervical mass with a minimal residual loco-regional disease, and even allowed surgical resection on one of them. Besides, a partial and complete response to the pulmonary metastatic disease was also observed[ 54 , 55 ].…”

Section: Selective Braf Inhibitorsmentioning

confidence: 99%

New approaches for patients with advanced radioiodine-refractory thyroid cancer

Pitoia¹,

Jerkovich²,

Trimboli³

et al. 2022

WJCO

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The cumulative evidence over the past decades has shown that the incidence of differentiated thyroid carcinoma (DTC) has exponentially increased. Approximately 10% of patients with DTC exhibit recurrent or metastatic disease, and about two-thirds of the latter will be defined as refractory to radioactive iodine (RAIR) treatment. Since this condition implies 10-year survival rates less than 10% after detection, using available treatments, such as systemic and targeted therapies, have become increasingly relevant. The initiation of these treatments aims to reach stabilization, tumor volume reduction, and/or symptom improvement and it should be decided by highly specialized endocrinologists/oncologists on the basis of patient’s features. Considering that despite enlarged progression-free survival was proven, multikinase inhibitors remain non-curative, their benefits last for a limited time and the side effects potentially cause harm and quality of life reduction. In this context, molecular testing of cancer cells provides a promising spectrum of targeted therapies that offer increased compatibility with individual patient needs by improving efficacy, progression free survival, overall survival and adverse events profile. This review article aims to provide a summary of the current therapeutic strategies in advanced RAIR-DTC, including approved target therapies as well as those for off-label use, RAI resensitization agents, and immunotherapy.

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Dramatic clinical response to dabrafenib plus trametinib in anaplastic thyroid carcinoma and the challenges faced during the COVID-19 pandemic

Cited by 3 publications

References 30 publications

Dabrafenib plus trametinib in patients with BRAF V600E-mutant anaplastic thyroid cancer: updated analysis from the phase II ROAR basket study

Dabrafenib plus trametinib in patients with BRAF V600E-mutant anaplastic thyroid cancer: updated analysis from the phase II ROAR basket study

Papillary Thyroid Cancer Trends in the Wake of the COVID-19 Pandemic: Is There a Shift toward a More Aggressive Entity?

New approaches for patients with advanced radioiodine-refractory thyroid cancer

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