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Thyroid. 2018 Jul;28(7):945-951. doi: 10.1089/thy.2018.0060. Epub 2018 Jun 29.

Neoadjuvant BRAF- and Immune-Directed Therapy for Anaplastic Thyroid Carcinoma.

Author information

1
1 Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center , Houston, Texas.
2
2 Department of Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, Texas.
3
3 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, Texas.
4
4 Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center , Houston, Texas.
5
5 Department of Pathology, The University of Texas MD Anderson Cancer Center , Houston, Texas.
6
6 Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center , Houston, Texas.
7
7 Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center , Houston, Texas.

Abstract

Anaplastic thyroid cancer (ATC) is a devastating disease with a dismal prognosis. Patients who have disease confined to the thyroid and who are able to undergo complete surgery and chemoradiation stand the best chance for survival. Unfortunately, nearly 50% of patients have distant metastases at diagnosis, and most present with locally advanced, unresectable tumors. Nevertheless, BRAF-mutated ATC patients represent a subset of cases who can benefit from a combination therapy with BRAF and MEK inhibitors. Here, a patient is presented with end-stage, locally advanced, unresectable ATC who was treated with this combination. Immunotherapy with pembrolizumab was added at the first sign of progression after which he achieved a partial response to therapy, enabling a complete surgical resection followed by postoperative chemoradiation to be undertaken. This novel neoadjuvant approach to BRAF-mutated ATC should be studied in further in clinical trials.

KEYWORDS:

dabrafenib; pembrolizumab; sarcomatoid; squamous; trametinib; undifferentiated

PMID:
29742974
PMCID:
PMC6425982
[Available on 2019-07-01]
DOI:
10.1089/thy.2018.0060
[Indexed for MEDLINE]

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