Evaluation of Overall Survival in Patients With Anaplastic Thyroid Carcinoma, 2000-2019

Maniakas, Anastasios; Dadu, Ramona; Busaidy, Naifa L.; Wang, Jennifer Rui; Ferrarotto, Renata; Lu, Charles; Williams, Michelle D.; Gunn, G. Brandon; Hofmann, Marie‐Claude; Cote, Gilbert J.; Sperling, Jared; Gross, Neil D.; Sturgis, Erich M.; Goepfert, Ryan P.; Lai, Stephen Y.; Cabanillas, Maria E.; Zafereo, Mark

doi:10.1001/jamaoncol.2020.3362

Cited by 197 publications

(166 citation statements)

References 20 publications

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“…There are anecdotal reports of combination therapy involving immunotherapy showing responses in ATC (287). In addition, there are now retrospective data to also indicate apparently improved ATC outcomes when immunotherapy is added to targeted therapy in ATC (OR 0.58, [CI 0.36-0.94], p = 0.03) (264).…”

Section: Immunotherapymentioning

confidence: 99%

“…As discussed throughout these guidelines, the rapidity of decision-making and quality of care in ATC from presentation, to diagnosis, to treatment initiation are critical to optimize ATC patient outcomes. A rapid diagnostic pathway (''FAST'') implemented by the MD Anderson Cancer Center to improve access to multidisciplinary care is yet to show improved outcomes, but referral rates have increased, and clinical trial enrollment is at an impressive 34% (264,319). Moreover, data from California indicate that clinical trial participation was independently associated with lower mortality in a population-based analysis across multiple cancer types (321).…”

Section: Good Practice Statement 15mentioning

confidence: 99%

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2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer

Bible

Kebebew

Brierley

et al. 2021

Thyroid

Self Cite

340

423

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Background: Anaplastic thyroid cancer (ATC) is a rare but highly lethal form of thyroid cancer. Since the guidelines for the management of ATC by the American Thyroid Association were first published in 2012, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, and researchers on published evidence relating to the diagnosis and management of ATC. Methods: The specific clinical questions and topics addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of the Task Force members (authors of the guideline). Relevant literature was reviewed, including serial PubMed searches supplemented with additional articles. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations. Results: The guidelines include the diagnosis, initial evaluation, establishment of treatment goals, approaches to locoregional disease (surgery, radiotherapy, targeted/systemic therapy, supportive care during active therapy), approaches to advanced/metastatic disease, palliative care options, surveillance and long-term monitoring, and ethical issues, including end of life. The guidelines include 31 recommendations and 16 good practice statements. Conclusions: We have developed evidence-based recommendations to inform clinical decision-making in the management of ATC. While all care must be individualized, such recommendations provide, in our opinion, optimal care paradigms for patients with ATC.

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Section: Immunotherapymentioning

confidence: 99%

Section: Good Practice Statement 15mentioning

confidence: 99%

2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer

Bible

Kebebew

Brierley

et al. 2021

Thyroid

Self Cite

340

423

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“…Due to the limitation of the data, we cannot draw further conclusions. Maniakas et al 30 pointed out that treatment of ATC has evolved from primarily palliation and hospice care to effective highly specialized molecular‐based personalized therapies and surgery when appropriate, regardless of disease stage. This will be the future development direction of ATC.…”

Section: Discussionmentioning

confidence: 99%

A relook at the 8th edition of the AJCC TNM staging system of anaplastic thyroid carcinoma: A SEER‐based study

Xiang

Wang

Sun

et al. 2020

Clinical Endocrinology

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Objective In the 8th edition American Joint Committee on Cancer (AJCC) tumour‐node‐metastasis (TNM) staging system (TNM‐8), changes have been made regarding anaplastic thyroid carcinoma (ATC) compared with the 7th edition (TNM‐7). The major changes are that anaplastic ATC now has the same T stage definitions as differentiated thyroid cancer, and new staging of IVA and IVB is implemented. However, the clinical impact of the new edition for ATC remains unclear due to scarce and conflicting data. In this study, we compared the AJCC TNM‐7 and TNM‐8 in the same group of patients. Design In this retrospective study, we included patients who were diagnosed with ATC between 2004 and 2015; data were gathered from the Surveillance, Epidemiology and End Results (SEER) database. Methods Overall survival (OS) was evaluated according to T stage and TNM stage according to the 7th and 8th editions. Kaplan–Meier and log‐rank testing was used to analyse OS. The effect of potential predictors was estimated using the Cox regression model. Results We included 669 patients in the study. The median age of the cohort was 70 years. During the follow‐up, 600 (89.7%) patients died, 528 of whom died of thyroid cancer. The TNM‐8 T staging more effectively predicted survival than the 7th edition (proportion of variation explained: 3.53% vs. 1.72%). However, the clinical stage was almost unchanged according to the TNM‐8 (proportion of variation explained: 10.69% vs. 10.73%). Conclusions The new T classification is an effective predictor of survival for patients with ATC. The results support the use of T definitions as per those of differentiated thyroid cancer. However, whether lymph node metastasis should be taken into account for defining ATC TNM staging should be reconsidered.

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“…ATC is one of the most aggressive tumors, with disease-specific mortality approaching 100% [ 50 , 51 , 52 ]. These tumors affect patients approximately 60 to 70 years of age.…”

Section: Phenotypic Heterogeneity Of Thyroid Cancermentioning

confidence: 99%

Thyroid Carcinoma: Phenotypic Features, Underlying Biology and Potential Relevance for Targeting Therapy

Yuan

Mirshahidi

et al. 2021

IJMS

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Thyroid carcinoma consists a group of phenotypically heterogeneous cancers. Recent advances in biological technologies have been advancing the delineation of genetic, epigenetic, and non-genetic factors that contribute to the heterogeneities of these cancers. In this review article, we discuss new findings that are greatly improving the understanding of thyroid cancer biology and facilitating the identification of novel targets for therapeutic intervention. We review the phenotypic features of different subtypes of thyroid cancers and their underlying biology. We discuss recent discoveries in thyroid cancer heterogeneities and the critical mechanisms contributing to the heterogeneity with emphases on genetic and epigenetic factors, cancer stemness traits, and tumor microenvironments. We also discuss the potential relevance of the intratumor heterogeneity in understanding therapeutic resistance and how new findings in tumor biology can facilitate designing novel targeting therapies for thyroid cancer.

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Evaluation of Overall Survival in Patients With Anaplastic Thyroid Carcinoma, 2000-2019

Cited by 197 publications

References 20 publications

2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer

2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer

A relook at the 8th edition of the AJCC TNM staging system of anaplastic thyroid carcinoma: A SEER‐based study

Thyroid Carcinoma: Phenotypic Features, Underlying Biology and Potential Relevance for Targeting Therapy

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