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- Title
Multimodal treatments and outcomes for anaplastic thyroid cancer before and after tyrosine kinase inhibitor therapy: a real-world experience.
- Authors
Jun Park; Hyun Ae Jung; Joon Ho Shim; Woong-Yang Park; Tae Hyuk Kim; Se-Hoon Lee; Sun Wook Kim; Myung-Ju Ahn; Keunchil Park; Jae Hoon Chung
- Abstract
Background: Anaplastic thyroid cancer (ATC) has dismal prognosis and there is no effective treatment. We aimed to evaluate the efficacy of tyrosine kinase inhibitor (TKI) therapy in real-world clinic and to suggest the most effective treatment modality according to the combination of treatments. Methods: This retrospective study evaluated clinical outcomes and cause of death with multimodal treatments in patients with ATC at Samsung Medical Center. Results: A total of 120 patients received anti-cancer treatment for ATC. Seventy-seven (64.2%) patients underwent surgery, 64 (53.3%) received radiotherapy, 29 (24.2%) received cytotoxic chemotherapy, and 19 (15.8%) received TKI therapy. In the TKI therapy group, eight achieved partial response (three with lenvatinib and five with dabrafenib plus trametinib), and two patients with lenvatinib showed stable disease. Median progression-free survival (PFS) of the TKI therapy group was 2.7 months (range: 0.1-12.7) and their median overall survival (OS) was 12.4 months (range: 1.7-47.7). Patients who received surgery or radiotherapy for local control showed superior OS than those who did not. In a multivariate analysis, surgery, TKI therapy, younger age, and no distant metastasis were associated with favorable OS. The combination of surgery, radiotherapy, and TKI therapy (median OS: 34.3 months, 6-month survival rates: 77.8%) was the most effective. Compared to the era without TKI therapy, distant metastasis has recently become the major cause of death in ATC over airway problems. Conclusions: Multimodality treatment including TKI therapy demonstrated pro longed survival with dabrafenib plus trametinib as the most effective therapeutic option demonstrated for BRAF mutant ATC patients.
- Subjects
ANAPLASTIC thyroid cancer; PROTEIN-tyrosine kinase inhibitors; TREATMENT effectiveness; OVERALL survival; CAUSES of death; SURVIVAL rate; COMBINED modality therapy
- Publication
European Journal of Endocrinology, 2021, Vol 184, Issue 6, p837
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-20-1482