3,118 results on '"differentiated thyroid cancer"'
Search Results
2. Larotrectinib to Enhance RAI Avidity in Differentiated Thyroid Cancer
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Bayer
- Published
- 2024
3. Compare the Effects of NLSCP and Interactive ICT Supported HAP on Differentiate Diagnosed Thyroid Cancer Patients
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- 2024
4. Thyroglobulin Point of Care Assay for Rapid Detection of Metastatic Differentiated Thyroid Carcinoma
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Uri Yoel MD, Dr.Uri Yoel
- Published
- 2024
5. Gender-based Impact on Safety and Efficacy of Lenvatinib in Patients With Differentiated Thyroid Cancer (Gisel)
- Author
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University of Turin, Italy, University of Roma La Sapienza, University of Siena, University of Pisa, Istituto Oncologico Veneto IRCCS, University of Catania, Istituto Auxologico Italiano, and Marialuisa Appetecchia, Professor
- Published
- 2024
6. Comparison of the Efficacy and Safety of rhTSH as An Adjunctive Diagnostic Tool in Differentiated Thyroid Cancer Patients Who Had Been Thyroidectomized Vs. Patients Who After Thyroid Hormone Withdrawal
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- 2024
7. A Study of Cabozantinib Compared With Placebo in Subjects With Radioiodine-refractory Differentiated Thyroid Cancer Who Have Progressed After Prior Vascular Endothelial Growth Factor Receptor (VEGFR) -Targeted Therapy
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Ipsen
- Published
- 2024
8. Clinical Trial of Dose-tolerance, Pharmacokinetics and Iodine Uptake For rhTSH In Post-thyroidectomized Patients
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- 2024
9. Pembrolizumab in High-risk Thyroid Cancer (NePenThe)
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Merck Sharp & Dohme LLC and Laura Deborah Locati, MD, PhD
- Published
- 2024
10. IDEntification of New Predisposition Genes in Differentiated THYroid Cancer (IDENTHY-K)
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- 2024
11. Recurrence in Patients With Differentiated Thyroid Cancer
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Sara Salah Mahmoud, Principal Investigator
- Published
- 2024
12. Sacituzumab govitEcan in THYroid Cancers (SETHY)
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MFAR and Gilead Sciences
- Published
- 2024
13. Targeted Therapy to Increase RAI Uptake in Metastatic DTC
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United States Department of Defense
- Published
- 2024
14. A Phase I/II Study of MLN0128 in Metastatic Anaplastic Thyroid Cancer and Incurably Poorly Differentiated or Radioidodine Refractory Differentiated Thyroid Cancer
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Millennium Pharmaceuticals, Inc. and Kartik Sehgal, MD, Principal Investigator
- Published
- 2024
15. Vitamin D receptor polymorphisms associate with the efficacy and toxicity of radioiodine-131 therapy in patients with differentiated thyroid cancer.
- Author
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Deng, Yuanhong, Fu, Ying, Feng, Ganghua, and Zhang, Yi
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VITAMIN D receptors , *SINGLE nucleotide polymorphisms , *THYROID cancer , *GENETIC polymorphisms , *POLYMORPHISM (Zoology) - Abstract
Radioiodine-131 (I-131) therapy is the common postoperative adjuvant therapy for differentiated thyroid cancer (DTC) However, methods to evaluate the efficacy and toxicity of I-131 on DTC are still lacking. To evaluate the association between vitamin D receptor (VDR) gene polymorphisms and the efficacy and toxicity of I-131 in DTC patients. A total of 256 DTC patients who received I-131 therapy were enrolled. The patients were divided into effective group and ineffective group. 4 single nucleotide polymorphisms (SNPs) (rs7975232, rs731236, rs1544410 and rs10735810) of VDR were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) Cell counting kit-8 (CCK-8) and flow cytometry were used to detect the proliferation and apoptosis of thyroid cancer cells. Patients in effective group had more CC genotype of rs7975232 and GG genotype of rs10735810 compared with patients in ineffective group They were also independent factors for influencing the efficacy of I-131. PTC-1 and FTC-133 cells transfected with CC genotype of rs7975232 showed lower proliferative activity and higher apoptosis rate after being treated with I-131 In addition, patients with CC genotype at rs7975232 had fewer adverse reactions after I-131 treatment. VDR gene polymorphisms may be associated with the efficacy and toxicity of I-131 in DTC patients, which will help to personalize the treatment for patients. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
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16. A predictive model for L-T4 dose in postoperative DTC after RAI therapy and its clinical validation in two institutions.
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Jian-Jing Liu, Zi-Yang Wang, Yuan-Fang Yue, Guo-Tao Yin, Li-Na Tong, Jie Fu, Xiao-Ying Ma, Yan Li, Xue-Yao Liu, Li-Bo Zhang, Qian Su, Zhao Yang, Xiao-Feng Li, Wen-Gui Xu, and Dong Dai
- Subjects
IODINE isotopes ,THYROTROPIN ,BODY surface area ,THYROID cancer ,LONGITUDINAL method - Abstract
Purpose: To develop a predictive model using machine learning for levothyroxine (L-T4) dose selection in patients with differentiated thyroid cancer (DTC) after resection and radioactive iodine (RAI) therapy and to prospectively validate the accuracy of the model in two institutions. Methods: Atotal of266DTCpatientswhoreceivedRAI therapy after thyroidectomy and achieved target thyroid stimulating hormone (TSH) level were included in this retrospective study. Sixteen clinical and biochemical characteristics that could potentially influence the L-T4 dose were collected; Significant features correlated with L-T4 dose were selected usingmachine learning randomforestmethod, and a total of eight regression models were established to assess their performance in prediction of L-T4 dose after RAI therapy; The optimalmodelwas validated through a two-center prospective study (n=263). Results: Six significant clinical and biochemical features were selected, including body surface area (BSA), weight, hemoglobin (HB), height, body mass index (BMI), and age. Cross-validation showed that the support vector regression (SVR) model was with the highest accuracy (53.4%) for prediction of L-T4 dose among the established eight models. In the two-center prospective validation study, a total of 263 patients were included. The TSH targeting rate based on constructed SVR model were dramatically higher than that basedonempiricaladministration (Rate 1 (first rate):52.09%(137/263) vs 10.53% (28/266); Rate 2 (cumulative rate): 85.55% (225/263) vs 53.38% (142/266)). Furthermore, themodel significantly shortens thetime (days) toachieve targetTSHlevel (62.61 ± 58.78 vs 115.50 ± 71.40). Conclusions: The constructed SVR model can effectively predict the L-T4 dose for postoperative DTC after RAI therapy, thus shortening the time to achieve TSH target level and improving the quality of life for DTC patients. [ABSTRACT FROM AUTHOR]
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- 2024
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17. Differentiated Thyroid Cancer in Children and Adolescents: 12-year Experience in a Single Center.
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Puga, Francisca Marques, Correia, Laura, Vieira, Inês, Caetano, Joana Serra, Cardoso, Rita, Dinis, Isabel, and Mirante, Alice
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LYMPH nodes , *THYROID gland tumors , *TUMORS in children , *CANCER relapse , *IODINE radioisotopes , *PAPILLARY carcinoma , *TREATMENT effectiveness , *RETROSPECTIVE studies , *METASTASIS , *THYROIDECTOMY , *DISEASE risk factors , *ADOLESCENCE , *CHILDREN - Abstract
Objective: Differentiated thyroid cancer (DTC) is the most common pediatric endocrine cancer but studies are scarce. Latest recommendations advocate for an individualized risk-based approach to select patients for additional therapy. Lymphovascular invasion is not considered, despite being a well-known risk factor in the adult population. The aim of this study was to describe the outcomes of a cohort of DTC patients diagnosed at pediatric age and to evaluate the impact of lymphovascular invasion on the risk of persistence/ recurrence. Methods: A retrospective study of patients diagnosed with DTC at pediatric age from 2010 to 2022 at a single center was performed. All patients had total thyroidectomy. Radioactive iodine therapy (RAI) was used in selected patients. The response to therapy and occurrence of persistent/recurrent disease were evaluated. Results: A total of 21 DTC were diagnosed, mostly papillary thyroid carcinoma (PTC) (81.0%, n=17). Six patients (28.6%) had nodal involvement and one (4.8%) had lung metastasis at the time of the diagnosis. Lymphovascular invasion was present in 11 patients (52.4%). After surgery, 13 patients (61.9%) underwent RAI. The mean follow-up time was 5.7±3.1 years. In total, 6 patients (31.6%) experienced persistent/recurrent disease during the follow-up time. Among PTC patients, persistent/recurrent disease was more frequent in the presence of lymphovascular invasion [55.6% (5/9) vs. 0.0% (0/6), p=0.031]. Conclusion: An individualized risk-based approach is recommended. Our study suggests that lymphovascular invasion may be associated with a higher risk of persistence/recurrence and should therefore be considered for decision making in children and adolescents with PTC. [ABSTRACT FROM AUTHOR]
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- 2024
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18. Dosimetry of 131I in remnant ablation and metastasis of differentiated thyroid cancer treated with high radioactivities and rhTSH.
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Rámirez-Franco, Jorge, Torres-García, Eugenio, Flores-Reyes, Mario, Torres-García, Gustavo, and Pérez-Soto, Elvia
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SCINTILLATION cameras , *ABSORBED dose , *MEDICAL dosimetry , *THYROID cancer , *THYROID hormones - Abstract
Purpose: Ruling out that healthy organs receive doses higher than those allowed in treatments with Iodo-131 (131I) for ablation of thyroid remnant is crucial for the radiological protection of the patient who also received the recombinant human thyroid-stimulating hormone (rhTSH). So, the investigation aimed to determine the changes in energy imparted by 131I in multiple organs due to the rhTSH in thyroid remnants and metastases of patients treated with high 131I activities (≥ 5,550 MBq). Materials and methods: Nine patients were divided into three groups (three per group); Group I included thyroid hormone withdrawal (THW) patients, while patients in groups II and III were stimulated with rhTSH. The activity and absorbed dose in regions of interest (ROIs) was quantified using the conjugated views method using gamma camera images. Results and discussion: Dosimetric variations of 131I produced by using rhTSH in the remnant thyroid (groups II and III) were observed, absorbed doses were minor for groups treated with rhTSH. Conclusion: The application of the high activities > 5,500 MBq administered together with the application of rhTSH is safe in dosimetric terms, also for 9250 MBq do not exceed established limits of absorbed dose in the bone marrow. Furthermore, these high activities provide more than three times the radiation dose to remaining thyroid tissue and approximately 1.5 times to metastases. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
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19. Advances in the selection and timing of postoperative radioiodine treatment in patients with differentiated thyroid carcinoma.
- Author
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Dai, Xin, Ren, Xinyi, Zhang, Jinyu, Zheng, Yuxin, Wang, Zhengjie, and Cheng, Gang
- Abstract
Differentiated thyroid cancer (DTC) is the most common endocrine malignancy. Patients who receive systematic care typically have a better prognosis. RAI treatment plays a key role in eradicating any remaining thyroid lesions in DTC patients, hence decreasing the risk of distant metastases and cancer recurrence. As research continues to advance, RAI treatment is becoming more and more individualized. Because of the excellent prognosis for DTC patients, there is a relatively broad window for RAI treatment, making it easy to overlook when to receive RAI treatment. However, research on this issue can help patients with varying recurrence risk stratification make better decisions about when to begin RAI treatment following surgery, and physicians can schedule patients based on the severity of their disease. This will improve patient prognosis and lessen needless anxiety in addition to helping solve the problems of unjust healthcare resource distribution. In this review, we will mainly discuss the target population of RAI treatment as well as studies that examine the impact of RAI treatment timing on patient outcomes. In an effort to discourage DTC patients and physicians from selecting RAI therapy at random, we also review the possible negative effects of this treatment. [ABSTRACT FROM AUTHOR]
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- 2024
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20. Recent advances in the use of tyrosine kinase inhibitors against thyroid cancer.
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Ferrari, Silvia Martina, Patrizio, Armando, Stoppini, Giulio, Elia, Giusy, Ragusa, Francesca, Balestri, Eugenia, Botrini, Chiara, Rugani, Licia, Barozzi, Emilio, Mazzi, Valeria, La Motta, Concettina, Antonelli, Alessandro, and Fallahi, Poupak
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TYROSINE ,THYROID cancer ,CELL growth ,CELL proliferation ,CLINICAL trials - Abstract
Introduction: Oncogenic tyrosine kinases (TK) are enzymes that play a key role in cell growth and proliferation and their mutations can lead to uncontrolled cell growth and development of aggressive cancer. This knowledge has led to the development of new classes of drugs, Tyrosine kinase inhibitors (TKI). They target oncogenic kinases who are associated with advanced radioactive iodine (RAI) refractory TC, which is not able to uptake RAI anymore and/or still grows between consecutive treatments with Iodine 131 (I131). Areas covered: Since Lenvatinib and Sorafenib approval, several other molecular inhibitors have been studied and then introduced for the treatment of aggressive and refractory thyroid cancer (TC), and, although the development of adverse effects or tumor resistance mechanisms, more and more compounds are still under investigation. The literature search was executed in PubMed and ClinicalTrials.gov to identify relevant articles and clinical trials published until December 2023. Expert opinion: In the context of clinical trials, driven by the presence of specific molecular mutations or even in the absence of both conditions, systemic therapy TKIs are valuable weapons to be used in patients affected by aggressive forms of TC, waiting for further expansion of the treatment landscape with more efficacious and safer drugs. [ABSTRACT FROM AUTHOR]
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- 2024
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21. Prognostic factors in children and adolescents with differentiated thyroid cancer treated with total thyroidectomy and radioiodine therapy: a retrospective two-center study from China.
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Congcong Wang, Yutian Li, Guoqiang Wang, Xinfeng Liu, Yingying Zhang, Chenghui Lu, Jiao Li, Na Han, Zenghua Wang, Zengmei Si, Fengqi Li, Gaixia Lu, Renfei Wang, and Xufu Wang
- Subjects
RECEIVER operating characteristic curves ,THYROID cancer ,MULTIVARIATE analysis ,IODINE isotopes ,UNIVARIATE analysis - Abstract
Purpose: This two-center study aimed to explore the main prognostic factors affecting the final disease status in children and adolescents with differentiated thyroid cancer (caDTC) following total thyroidectomy and radioiodine therapy (RAIT). Materials and Methods: All caDTC patients from two centers in the period from 2004-2022 were retrospectively included. At the last follow-up, the patients' disease status was assessed and classified as an incomplete response (IR) or as an excellent or indeterminate response (EIDR). Then, the difference in preablation stimulated thyroglobulin (ps-Tg) levels between the two groups was compared, and the threshold for predicting IR was determined using receiver operating characteristic (ROC) analysis. Moreover, univariate and multivariate analyses were conducted to identify the factors influencing the patients' ultimate disease outcomes. Results: A total of 143 patients (98 females, 45 males; median age 16 years) were recruited. After a median follow-up of 42.9 months, 80 patients (55.9%) exhibited an EIDR, whereas 63 patients (44.1%) exhibited an IR. Patients with an IR had significantly greater ps-Tg levels than did those with an EIDR (median ps-Tg 79.2 ng/mL vs. 9.3 ng/mL, p<0.001). The ROC curve showed that ps-Tg =20 ng/mL was the most accurate for predicting IR at the last follow-up. According to multivariate analysis, only ps-Tg, T stage and the therapeutic response to initial RAIT were significantly associated with IR. Conclusion: In caDTC patients, the ps-Tg level, T stage, and response to initial RAIT are critical final outcome indicators. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
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22. Vandetanib in locally advanced or metastatic differentiated thyroid cancer refractory to radioiodine therapy.
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Brose, Marcia S., Capdevila, Jaume, Elisei, Rossella, Bastholt, Lars, Führer-Sakel, Dagmar, Leboulleux, Sophie, Iwao Sugitani, Taylor, Matthew H., Zhuoying Wang, Wirth, Lori J., Worden, Francis P., Bernard, John, Caferra, Paolo, Colzani, Raffaella M., Shiguang Liu, and Schlumberger, Martin
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THYROID cancer , *CLINICAL trials , *IODINE isotopes , *TERMINATION of treatment , *PROTEIN-tyrosine kinases , *PROGRESSION-free survival - Abstract
The VERIFY study aimed to determine the efficacy of vandetanib in patients with differentiated thyroid cancer (DTC) that is either locally advanced or metastatic and refractory to radioiodine (RAI) therapy. Specifically, VERIFY is a randomized, double-blind, multicenter phase III trial aimed to determine the efficacy and safety of vandetanib in tyrosine kinase inhibitor-naive patients with locally advanced or metastatic RAI-refractory DTC with documented progression (NCT01876784). Patients were randomized 1:1 to vandetanib or placebo. The primary endpoint was progression-free survival (PFS). Secondary endpoints included best objective response rate, overall survival (OS), safety, and tolerability. Patients continued to receive randomized treatment until disease progression or for as long as they were receiving clinical benefit unless criteria for treatment discontinuation were met. Following randomization, 117 patients received vandetanib, and 118 patients received a placebo. Median PFS was 10.0 months in the vandetanib group and 5.7 months in the placebo group (hazard ratio: 0.75; 95% CI: 0.55–1.03; P = 0.080). OS was not significantly different between treatment arms. Common Terminology Criteria for Adverse Events (CTCAE) of grade ≥3 were reported in 55.6% of patients in the vandetanib arm and 25.4% in the placebo arm. Thirty-three deaths (28.2%; one related to study treatment) occurred in the vandetanib arm compared with 16 deaths (13.6%; two related to treatment) in the placebo arm. No statistically significant improvement was observed in PFS in treatment versus placebo in patients with locally advanced or metastatic, RAI-refractory DTC. Moreover, active treatment was associated with more adverse events and more deaths than placebo, though the difference in OS was not statistically significant. [ABSTRACT FROM AUTHOR]
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- 2024
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23. Ten years' real-life experience on the use of multikinase inhibitors in patients with advanced differentiated thyroid cancer.
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Jerkovich, Fernando, Capalbo, Soledad, Abelleira, Erika, and Pitoia, Fabián
- Abstract
Purpose: To evaluate objective response rates (ORR), progression-free survival (PFS), and overall survival (OS) associated with tyrosine kinase inhibitors (TKIs) in patients with radioiodine refractory differentiated thyroid cancer (RR-DTC). Additionally, to compare: (i) ORR and PFS among patients treated with lenvatinib and sorafenib; (ii) ORR and PFS among patients receiving lenvatinib as first-line vs. second-line and; (iii) adverse effects (AEs) observed in patients treated with these medications. Methods: Retrospective analysis of RR-DTC adult patients treated with TKIs at the Division of Endocrinology, Hospital de Clinicas, University of Buenos Aires (March 2011–November 2023). Results: Among 43 patients included in the study, 32 received sorafenib (30 as first-line and 2 as second-line), while 29 received lenvatinib (12 as first-line and 17 as second-line). The median PFS and OS for the entire cohort were 32.7 and 39.0 months, respectively. Lenvatinib demonstrated a significantly higher ORR compared to sorafenib (37.9% vs. 9.4%, p = 0.008). However, both drugs exhibited similar median PFS (23.2 vs. 16.0 months, p = 0.419). No significant difference was observed in ORR and PFS between patients receiving first-line vs. second-line lenvatinib. Sorafenib-treated patients experienced higher rates of hand-foot skin syndrome (69% vs. 41%, p = 0.032) and alopecia (25% vs. 3%, p = 0.018), whereas lenvatinib-treated patients had higher rates of proteinuria (31% vs. 0%, p < 0.001) and grade 3 hypertension (31% vs. 9%, p = 0.034). Conclusion: TKIs demonstrated efficacy and tolerability comparable to real-world data in RR-DTC. PFS was not statistically different between sorafenib and lenvatinib. Our study will help guide physicians in making informed decisions regarding treatment sequencing with TKIs in these patients. [ABSTRACT FROM AUTHOR]
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- 2024
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24. Impact of Tumor Size on Prognosis in Differentiated Thyroid Cancer with Gross Extrathyroidal Extension to Strap Muscles: Redefining T3b.
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Park, Joonseon, An, Solji, Bae, Ja Seong, Kim, Kwangsoon, and Kim, Jeong Soo
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RISK assessment , *THYROID gland tumors , *RECEIVER operating characteristic curves , *NECK muscles , *DESCRIPTIVE statistics , *PROGRESSION-free survival , *COMPARATIVE studies , *TUMOR classification , *OVERALL survival ,MORTALITY risk factors - Abstract
Simple Summary: This study investigated the impact of tumor size on T3b differentiated thyroid cancer prognosis. No significant difference was found in the prognosis of small T3b tumors compared to the T1 tumors. Disease-specific survival, disease-free survival, and overall survival were significantly lower only in large T3b tumors compared to T2 and T3a. If T3b tumors are 2 cm or smaller, downstaging may be considered. The modified T category, reclassifying T3b (≤2 cm) as T1, showed better staging performance than the existing category. Adopting this modified T category could improve the prognostic accuracy of the AJCC/TNM staging. The prognostic significance of tumor size in T3b differentiated thyroid cancer (DTC) remains debated and underexplored. This study aimed to examine the varying impact of T3b based on tumor size, analyzing disease-specific survival, disease-free survival, and overall survival. A retrospective review of 6282 DTC patients who underwent thyroid surgery at Seoul St. Mary's Hospital from September 2000 to December 2017 was conducted. T3b was classified into three subcategories, T3b-1 (≤2 cm), T3b-2 (2–4 cm), and T3b-3 (>4 cm), using the same size criteria for T1, T2, and T3a. T3b-1 showed no significant difference in disease specific survival compared to T1, and both disease-free and disease-specific survival curves were sequentially ranked as T1, T3b-1, T2, T3a, T3b-2, and T3b-3. The modified T category, reclassifying T3b-1 as T1, demonstrated superior staging performance compared to the classic T category (c-index: 0.8961 vs. 0.8959 and AUC: 0.8573 vs. 0.8518). Tumors measuring 2 cm or less within the T3b category may require downstaging, and a modified T category could improve the precision of prognostic staging compared to the current T category. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Current Advances in Radioactive Iodine-Refractory Differentiated Thyroid Cancer.
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Volpe, Fabio, Nappi, Carmela, Zampella, Emilia, Di Donna, Erica, Maurea, Simone, Cuocolo, Alberto, and Klain, Michele
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THYROID cancer , *IODINE isotopes , *SOMATOSTATIN receptors , *PROTEIN-tyrosine kinase inhibitors , *PROGNOSIS - Abstract
Background: Differentiated thyroid cancer (DTC) patients have an outstanding overall long-term survival rate, and certain subsets of DTC patients have a very high likelihood of disease recurrence. Radioactive iodine (RAI) therapy is a cornerstone in DTC management, but cancer cells can eventually develop resistance to RAI. Radioactive iodine-refractory DTC (RAIR-DTC) is a condition defined by ATA 2015 guidelines when DTC cannot concentrate RAI ab initio or loses RAI uptake ability after the initial therapy. The RAIR condition implies that RAI cannot reveal new met-astatic foci, so RAIR-DTC metabolic imaging needs new tracers. 18F-FDG PET/CT has been widely used and has demonstrated prognostic value, but 18F-FDG DTC avidity may remain low. Fibroblast activation protein inhibitors (FA-Pi)s, prostatic-specific membrane antigen (PSMA), and somatostatin receptor (SSTR) tracers have been proposed as theragnostic agents in experimental settings and Arg-Gly-Asp (RGD) peptides in the diagnostic trial field. Multi-targeted tyrosine kinase inhibitors are relatively new drugs approved in RAIR-DTC therapy. Despite the promising targeted setting, they relate to frequent adverse-event onset. Sorafenib and trametinib have been included in re-differentiation protocols aimed at re-inducing RAI accumulation in DTC cells. Results appear promising, but not excellent. Conclusions: RAIR-DTC remains a challenging nosological entity. There are still controversies on RAIR-DTC definition and post-RAI therapy evaluation, with post-therapy whole-body scan (PT-WBS) the only validated criterion of response. The recent introduction of multiple diagnostic and therapeutic agents obliges physicians to pursue a multidisciplinary approach aiming to correct drug introduction and timing choice. [ABSTRACT FROM AUTHOR]
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- 2024
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26. The methodological and reporting quality of randomized controlled trials of tyrosine kinase inhibitors for advanced differentiated thyroid cancer: Meta‐research study.
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Dedivitis, Rogério Aparecido, Castro, Mario Augusto Ferrari de, Boni, Alice Matos Dal, Alvares, Ana Carolina Beltrão, Tresso, Ana Júlia Piazentin, Oliveira, Andrea Davedovicz de, Vieira, Amanda Gonçalves da Silva Dourado, Mendes, Fernanda Assaf, Rossi, Giovana de Oliveira, Fava, Giullia Neworal, Pouza, Isabela Santos, Santana, Izabelle Pimenta, Laino, Julia Gibran, Lima, Letícia Barbosa de, and Martimbianco, Ana Luiza Cabrera
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PROTEIN-tyrosine kinase inhibitors ,THYROID cancer ,RANDOMIZED controlled trials ,CLINICAL trials ,OVERALL survival - Abstract
Introduction: Clinical trials on tyrosine kinase inhibitors (TKI) treatment have shown an improvement in overall and progression‐free survival in patients with advanced differentiated thyroid cancer. However, it is necessary to evaluate these studies to assess methodological biases and inconsistencies that may impact the effects. Objective: To map and assess the methodological quality of randomized clinical trials (RCTs) regarding randomization, allocation concealment, blinding, and selective reporting bias. Methods: RCTs assessing the efficacy and safety of TKI for the treatment of advanced differentiated thyroid cancer were included. The search was performed in the MEDLINE database. The included RCTs were assessed for the adequacy of the methodological steps, as recommended by the Cochrane Risk of Bias tool. Results: Nine studies were analyzed, of which 77.7% were classified as low risk of bias regarding selective reporting and 33.3% as high risk of reporting bias. The mean time between protocol registration and study publication was approximately 5.11 years. Moreover, 66.7% were classified as low risk of bias for randomization and allocation concealment, and 33.3% did not specify the randomization process and allocation concealment in a way that would allow the identification of occurrences of bias. Concerning blinding of participants and outcome assessors, 77.8% of the RCTs reported adequate blinding and were classified as having a low risk of bias, 11.1% had a high risk of bias, and 11.1% had insufficient information and were classified as having unclear risk of bias. Regarding the blinding of the outcome assessors, 33.3% did the blinding correctly, 11.1% did not blind, and 55.6% did not provide enough information. Conclusion: Overall, the assessed RCTs were predominantly at low risk of bias. The critical evaluation of these studies is essential to have confidence in the treatment estimated effect that will support clinical decision‐making and provide information to preclude future clinical study flaws. [ABSTRACT FROM AUTHOR]
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- 2024
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27. Molecular imaging of thyroid and parathyroid diseases.
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Petranović Ovčariček, Petra, Calderoni, Letizia, Campenni, Alfredo, Fanti, Stefano, and Giovanella, Luca
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THYROID diseases ,MEDULLARY thyroid carcinoma ,PARATHYROID glands ,LITERATURE reviews ,THYROID cancer ,THYROID nodules ,THYROID gland - Abstract
Molecular imaging of thyroid and parathyroid diseases has changed in recent years due to the introduction of new radiopharmaceuticals and new imaging techniques. Accordingly, we provided an clinicians-oriented overview of such techniques and their indications. A review of the literature was performed in the PubMed, Web of Science, and Scopus without time or language restrictions through the use of one or more fitting search criteria and terms as well as through screening of references in relevant selected papers. Literature up to and including December 2023 was included. Screening of titles/abstracts and removal of duplicates was performed and the full texts of the remaining potentially relevant articles were retrieved and reviewed. Thyroid and parathyroid scintigraphy remains integral in patients with thyrotoxicosis, thyroid nodules, differentiated thyroid cancer and, respectively, hyperparathyroidism. In the last years positron-emission tomography with different tracers emerged as a more accurate alternative in evaluating indeterminate thyroid nodules [
18 F-fluorodeoxyglucose (FDG)], differentiated thyroid cancer [124 I-iodide,18 F-tetrafluoroborate,18 F-FDG] and hyperparathyroidism [18F-fluorocholine]. Other PET tracers are useful in evaluating relapsing/advanced forms of medullary thyroid cancer (18 F-FDOPA) and selecting patients with advanced follicular and medullary thyroid cancers for theranostic treatments (68 Ga/177 Ga-somatostatin analogues). [ABSTRACT FROM AUTHOR]- Published
- 2024
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28. Differentiated Thyroid Cancer in Children and Adolescents: 12-year Experience in a Single Center
- Author
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Francisca Marques Puga, Laura Correia, Inês Vieira, Joana Serra Caetano, Rita Cardoso, Isabel Dinis, and Alice Mirante
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differentiated thyroid cancer ,papillary thyroid cancer ,children and adolescents ,pediatric ,lymphovascular invasion ,persistence ,recurrence ,Pediatrics ,RJ1-570 ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
INTRODUCTION: Differentiated thyroid cancer (DTC) is the most common pediatric endocrine cancer but studies are scarce. Latest recommendations advocate for an individualized risk-based approach to select patients for additional therapy. Lymphovascular invasion is not considered, despite being a well-known risk factor in the adult population. The aim of this study was to describe the outcomes of a cohort of DTC patients diagnosed at pediatric age and to evaluate the impact of lymphovascular invasion on the risk of persistence/recurrence. METHODS: A retrospective study of patients diagnosed with DTC at pediatric age from 2010 to 2022 at a single center was performed. All patients had total thyroidectomy. Radioactive iodine therapy (RAI) was used in selected patients. The response to therapy and occurrence of persistent/recurrent disease were evaluated. RESULTS: A total of 21 DTC were diagnosed, mostly papillary thyroid carcinoma (PTC) (81.0%, n=17). Six patients (28.6%) had nodal involvement and one (4.8%) had lung metastasis at the time of the diagnosis. Lymphovascular invasion was present in 11 patients (52.4%). After surgery, 13 patients (61.9%) underwent RAI. The mean follow-up time was 5.7±3.1 years. In total, 6 patients (31.6%) experienced persistent/recurrent disease during the follow-up time. Among PTC patients, persistent/recurrent disease was more frequent in the presence of lymphovascular invasion [55.6% (5/9) vs. 0.0% (0/6), p=0.031]. DISCUSSION AND CONCLUSION: An individualized risk-based approach is recommended. Our study suggests that lymphovascular invasion may be associated with a higher risk of persistence/recurrence and should therefore be considered for decision making in children and adolescents with PTC.
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- 2024
- Full Text
- View/download PDF
29. Current Advances in Radioactive Iodine-Refractory Differentiated Thyroid Cancer
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Fabio Volpe, Carmela Nappi, Emilia Zampella, Erica Di Donna, Simone Maurea, Alberto Cuocolo, and Michele Klain
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radioactive iodine ,therapy ,theragnostics ,differentiated thyroid cancer ,refractory DTC ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Differentiated thyroid cancer (DTC) patients have an outstanding overall long-term survival rate, and certain subsets of DTC patients have a very high likelihood of disease recurrence. Radioactive iodine (RAI) therapy is a cornerstone in DTC management, but cancer cells can eventually develop resistance to RAI. Radioactive iodine-refractory DTC (RAIR-DTC) is a condition defined by ATA 2015 guidelines when DTC cannot concentrate RAI ab initio or loses RAI uptake ability after the initial therapy. The RAIR condition implies that RAI cannot reveal new met-astatic foci, so RAIR-DTC metabolic imaging needs new tracers. 18F-FDG PET/CT has been widely used and has demonstrated prognostic value, but 18F-FDG DTC avidity may remain low. Fibroblast activation protein inhibitors (FA-Pi)s, prostatic-specific membrane antigen (PSMA), and somatostatin receptor (SSTR) tracers have been proposed as theragnostic agents in experimental settings and Arg-Gly-Asp (RGD) peptides in the diagnostic trial field. Multi-targeted tyrosine kinase inhibitors are relatively new drugs approved in RAIR-DTC therapy. Despite the promising targeted setting, they relate to frequent adverse-event onset. Sorafenib and trametinib have been included in re-differentiation protocols aimed at re-inducing RAI accumulation in DTC cells. Results appear promising, but not excellent. Conclusions: RAIR-DTC remains a challenging nosological entity. There are still controversies on RAIR-DTC definition and post-RAI therapy evaluation, with post-therapy whole-body scan (PT-WBS) the only validated criterion of response. The recent introduction of multiple diagnostic and therapeutic agents obliges physicians to pursue a multidisciplinary approach aiming to correct drug introduction and timing choice.
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- 2024
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30. Suspected Malignancy and Malignant Thyroid Tumors
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Paladino, Nunzia Cinzia, Taïeb, David, Sebag, Frédéric, Testini, Mario, editor, and Gurrado, Angela, editor
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- 2024
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31. Hemithyroidectomy or Total-Thyroidectomy in 'Low-risk' Thyroid Cancers (HoT)
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National Institute for Health Research, United Kingdom
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- 2023
32. Lenvatinib in Locally Advanced Invasive Thyroid Cancer
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Eisai Inc. and Gregory Randolph, MD, Professor of Otolaryngology Head and Neck Surgery
- Published
- 2023
33. Efficacy and Safety Study of rhTSH for Adjuvant Radioiodine Ablation Therapy in Patients With Differentiated Thyroid Cancer
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- 2023
34. The Safety and Effectiveness of rhTSH in Radioiodine Treatment for Patients With Differentiated Thyroid Cancer. (DTC)
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- 2023
35. Reinducing Radioiodine-sensitivity in Radioiodine-refractory DTC Using Lenvatinib (RESET) (RESET)
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HW Kapiteijn, Medical Oncologist, Associate Professor Research and Treatment of Rare Cancers
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- 2023
36. Automatic prediction of non-iodine-avid status in lung metastases for radioactive I131 treatment in differentiated thyroid cancer patients.
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Xinyi Gao, Haoyi Chen, Yun Wang, Feijia Xu, Anni Zhang, Yong Yang, and Yajia Gu
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THYROID gland ,LUNGS ,THYROID cancer ,CANCER patients ,RECEIVER operating characteristic curves ,IODINE isotopes ,DEEP learning - Abstract
Objectives: The growing incidence of differentiated thyroid cancer (DTC) have been linked to insulin resistance and metabolic syndrome. The imperative need for developing effective diagnostic imaging tools to predict the non-iodine-avid status of lung metastasis (LMs) in differentiated thyroid cancer (DTC) patients is underscored to prevent unnecessary radioactive iodine treatment (RAI). Methods: Primary cohort consisted 1962 pretreated LMs of 496 consecutive DTC patients with pretreated initially diagnosed LMs who underwent chest CT and subsequent post-treatment radioiodine SPECT. After automatic lesion segmentation by SE V-Net, SE Net deep learning was trained to predict noniodine-avid status of LMs. External validation cohort contained 123 pretreated LMs of 24 consecutive patients from other two hospitals. Stepwise validation was further performed according to the nodule's largest diameter. Results: The SE-Net deep learning network yielded area under the receiver operating characteristic curve (AUC) values of 0.879 (95% confidence interval: 0.852-0.906) and 0.713 (95% confidence interval: 0.613-0.813) for internal and external validation. With the LM diameter decreasing from =10mm to =4mm, the AUCs remained relatively stable, for smallest nodules (=4mm), the model yielded an AUC of 0.783. Decision curve analysis showed that most patients benefited using deep learning to decide radioactive I131 treatment. Conclusion: This study presents a noninvasive, less radioactive and fully automatic approach that can facilitate suitable DTC patient selection for RAI therapy of LMs. Further prospective multicenter studies with larger study cohorts and related metabolic factors should address the possibility of comprehensive clinical transformation. [ABSTRACT FROM AUTHOR]
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- 2024
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37. Circulating endogenous sex steroids and risk of differentiated thyroid carcinoma in men and women.
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Rinaldi, Sabina, Dossus, Laure, Keski‐Rahkonen, Pekka, Kiss, Agneta, Navionis, Anne‐Sophie, Biessy, Carine, Travis, Ruth, Weiderpass, Elisabete, Romieu, Isabelle, Eriksen, Anne Kirstine, Tjonneland, Anne, Kvaskoff, Marina, Canonico, Marianne, Truong, Thérèse, Katzke, Verena, Kaaks, Rudolf, Catalano, Alberto, Panico, Salvatore, Masala, Giovanna, and Tumino, Rosario
- Abstract
Thyroid cancer (TC) is substantially more common in women than in men, pointing to a possible role of sex steroid hormones. We investigated the association between circulating sex steroid hormones, sex hormone binding globulin (SHBG) and the risk of differentiated TC in men and women within the European Prospective Investigation into Cancer and nutrition (EPIC) cohort. During follow‐up, we identified 333 first primary incident cases of differentiated TC (152 in pre/peri‐menopausal women, 111 in post‐menopausal women, and 70 in men) and 706 cancer‐free controls. Women taking exogenous hormones at blood donation were excluded. Plasma concentrations of testosterone, androstenedione, dehydroepiandrosterone, estradiol, estrone and progesterone (in pre‐menopausal women only) were performed using liquid chromatography/mass spectrometry method. SHBG concentrations were measured by immunoassay. Odds ratios (ORs) were estimated using conditional logistic regression models adjusted for possible confounders. No significant associations were observed in men and postmenopausal women, while a borderline significant increase in differentiated TC risk was observed with increasing testosterone (adjusted OR T3 vs T1: 1.68, 95% CI: 0.96–2.92, ptrend =.06) and androstenedione concentrations in pre/perimenopausal women (adjusted OR T3 vs T1: 1.78, 95% CI: 0.96–3.30, ptrend =.06, respectively). A borderline decrease in risk was observed for the highest progesterone/estradiol ratio (adjusted OR T3 vs T1: 0.54, 95% CI: 0.28–1.05, ptrend =.07). Overall, our results do not support a major role of circulating sex steroids in the etiology of differentiated TC in post‐menopausal women and men but may suggest an involvement of altered sex steroid production in pre‐menopausal women. [ABSTRACT FROM AUTHOR]
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- 2024
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38. Initial results of the INSPIRE clinical trial--investigating radiation dosimetry for differentiated thyroid cancer patients.
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Taprogge, Jan, Abreu, Carla, Vávrová, Lenka, Carnegie-Peake, Lily, Rushforth, Dominic, Gape, Paul, Gear, Jonathan, Murray, Iain, Wong, Kee H., Newbold, Kate, Yusuf, Siraj, and Flux, Glenn
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THYROID gland tumors ,IODINE radioisotopes ,BLOOD testing ,THYROID gland function tests ,SCIENTIFIC observation ,COMPUTED tomography ,RADIATION dosimetry ,TREATMENT effectiveness ,CANCER patients ,DESCRIPTIVE statistics ,LONGITUDINAL method ,PATIENT-centered care ,QUALITY of life ,RESEARCH ,RADIATION doses ,DATA analysis software ,THYROIDECTOMY - Abstract
Introduction: The optimal strategy for differentiated thyroid cancer (DTC) patients treated with radioiodine (RAI) following thyroidectomy remains controversial. Multi-centre clinical studies are essential to identify strategies to improve patient outcomes while minimising treatment-induced toxicity. Materials and Methods: The INSPIRE clinical trial (ClinicalTrials.gov Identifier: NCT04391244) aims to investigate patient-specific dosimetry for DTC patients and to determine the range of absorbed doses delivered to target and nontarget tissues and their relationship with treatment outcome and toxicity. Results: We report here initial results of the first 30 patients enrolled onto the INSPIRE trial. A large range of absorbed doses are observed for both thyroid remnants and salivary glands, with median values of 4.8 Gy (Range 0.2 - 242 Gy) and 0.3 Gy (Range 0.1 to 1.7 Gy), respectively. Discussion: The preliminary study results are encouraging and could help to improve our understanding of absorbed doses to thyroid remnants and normal organs following RAI therapy. Such knowledge could potentially enable patientspecific treatment planning with improved clinical outcomes and quality-of-life of patients. [ABSTRACT FROM AUTHOR]
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- 2024
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39. Development of a predictive nomogram for intermediate-risk differentiated thyroid cancer patients after fixed 3.7GBq (100mCi) radioiodine remnant ablation.
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Lu Lu, Qiang Li, Zhao Ge, Yanqi Lu, Chunhao Lin, Jinfu Lv, Jinquan Huang, Xingyu Mu, and Wei Fu
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THYROID cancer ,NOMOGRAPHY (Mathematics) ,IODINE isotopes ,AUTOIMMUNE thyroiditis ,CANCER patients ,LYMPHADENECTOMY ,RESAMPLING (Statistics) - Abstract
Objectives: The objective of this study was to develop a predictive nomogram for intermediate-risk differentiated thyroid cancer (DTC) patients after fixed 3.7GBq (100mCi) radioiodine remnant ablation (RRA). Methods: Data from 265 patients who underwent total thyroidectomy with central lymph node dissection (CND) and received RRA treatment at a single institution between January 2018 and March 2023 were analyzed. Patients with certain exclusion criteria were excluded. Univariate and multivariate logistic regression analyses were performed to identify risk factors for a non-excellent response (non-ER) to RRA. A nomogram was developed based on the risk factors, and its performance was validated using the Bootstrap method with 1,000 resamplings. A web-based dynamic calculator was developed for convenient application of the nomogram. Results: The study included 265 patients with intermediate-risk DTC. Significant differences were found between the ER group and the non-ER group in terms of CLNM>5, Hashimoto's thyroiditis, sTg level, TgAb level (P < 0.05). CLNM>5 and sTg level were identified as independent risk factors for non-ER in multivariate analysis. The nomogram showed high accuracy, with an area under the curve (AUC) of 0.833 (95% CI = 0.770-0.895). The nomogram's predicted probabilities aligned closely with actual clinical outcomes. Conclusions: This study developed a predictive nomogram for intermediate-risk DTC patients after fixed 3.7GBq (100mCi) RRA. The nomogram incorporates CLNM>5 and sTg levels as risk factors for a non-ER response to RRA. The nomogram and web-based calculator can assist in treatment decision-making and improve the precision of prognosis information. Further research and validation are needed. [ABSTRACT FROM AUTHOR]
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- 2024
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40. Clinicopathological parameters associated with cervical lymph node metastases in differentiated thyroid cancer.
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Doğan, Hayriye Tatlı, Kılıçarslan, Aydan, Çağlayan, Ayça Dilşad, and Sungu, Nuran
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- *
LYMPH nodes , *RISK assessment , *ADENOCARCINOMA , *THYROID gland tumors , *SURGERY , *PATIENTS , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *METASTASIS , *SURGICAL margin , *CANCER patient psychology , *THYROIDECTOMY , *NECK surgery - Abstract
Background: Lymph node metastasis (LNM) has an important role for the prognosis of differentiated thyroid cancer (DTC). The aim of the study was to investigate the effect of clinicopathologic parameters on cervical LNM in DTC. Methods: The patients who underwent thyroidectomy along with neck dissection were analyzed retrospectively. Results: Of the 150 patients diagnosed with DTC who underwent neck dissection, 1 had follicular thyroid carcinoma and 149 had papillary thyroid carcinoma (PTC). The median tumor size was 14.0 mm. The tumor diameter with the highest specificity and sensitivity for the detection of LNM was ≥11.5 mm. Extrathyroidal extension (ETE) was observed in 35.3% of the patients. The rate of multifocality in tumors with extrathyroidal spread was significantly higher than in tumors without ETE. LNM was observed in 60.0% of the patients. ETE was present in 28.9% of the tumors that had LNM. Lymphovascular invasion (LVI), perineural invasion (PNI), and positive surgical margin were observed in 13.3%, 2.7%, and 14% of the patients respectively. A significant positive correlation was found between LNM and tumor diameter, ETE, positive tumor margin and LVI (Pp = .006, P = .031, P = .002, and P = .014, respectively). Conclusion: In this study, ETE, LVI, positive tumor margin, and tumor diameter greater than 11.5 mm were significantly correlated with the presence of LNM. These findings may be useful in bringing to mind the possibility of lymph node metastases that have not been able to be detected before surgery and in monitoring these patients more closely. [ABSTRACT FROM AUTHOR]
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- 2024
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41. Longitudinal Changes in Quality of Life Before and After Thyroidectomy in Patients With Differentiated Thyroid Cancer.
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Kim, Byung Hun, Ryu, Soo Rack, Lee, Jin Won, Song, Chang Myeon, Ji, Yong Bae, Cho, Seok Hyun, Lee, Seung Hwan, and Tae, Kyung
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THYROID cancer ,THYROIDECTOMY ,QUALITY of life ,IODINE isotopes ,THYROID gland ,LARYNGEAL nerves ,DEEP brain stimulation ,SATISFACTION - Abstract
Objective The objective of this prospective study was to assess longitudinal variations in health-related quality of life (HR-QOL) in patients diagnosed with differentiated thyroid cancer (DTC) before and after thyroidectomy. Methods A cohort of 185 DTC patients who underwent thyroidectomy between January 2013 and December 2017 and who completed all necessary questionnaires was evaluated. Their HR-QOL was gauged using the University of Washington Quality of Life questionnaire (UW-QOL) and the City of Hope Quality of Life-Thyroid Version questionnaire (QOL-TV) both prior to surgery and at 3 months, 6 months, 1 year, 2 years, 3 years, and 5 years postoperatively. Results Out of 185 patients, 150 (81.1%) were female, with an average age of 48.7 ± 12.9 years. For both UW-QOL and QOL-TV, the total composite QOL scores notably declined from preoperative levels to 3 months postoperatively, then gradually improved over 5 years, ultimately exceeding preoperative scores. Factors such as total thyroidectomy, radioactive iodine (RAI) ablation, and postoperative hypoparathyroidism were associated with lower physical composite QOL scores. Patients who underwent remote-access thyroidectomy expressed significantly higher satisfaction with appearance compared with those who had conventional thyroidectomy. Mood and anxiety were major clinical concerns both before and after surgery, showing considerable improvement postoperatively. Conclusion For DTC patients, HR-QOL experienced a significant drop 3 months postsurgery, subsequently showing gradual improvement, surpassing preoperative QOL by 5 years. Factors contributing to improved physical QOL included the utilization of remote-access thyroidectomy, less extensive thyroidectomy, and the absence of RAI ablation and hypoparathyroidism. [ABSTRACT FROM AUTHOR]
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- 2024
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42. Radioactive iodine refractoriness in Middle Eastern differentiated thyroid cancer: clinical outcome and risk factor analysis.
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Parvathareddy, Sandeep Kumar, Siraj, Abdul K., Siraj, Nabil, Ahmed, Saeeda O., Al-Rasheed, Maha, Qadri, Zeeshan, Siddiqui, Khawar, Al-Sobhi, Saif S., Al-Dayel, Fouad, and Al-Kuraya, Khawla S.
- Subjects
IODINE isotopes ,THYROID cancer ,FACTOR analysis ,TELOMERASE reverse transcriptase ,PROPORTIONAL hazards models - Abstract
Background: Radioactive iodine refractory differentiated thyroid cancer (RAIRDTC) has received increasing attention due to its poor prognosis. However, outcomes may vary among patients with RAIR-DTC. The role of clinicopathological and molecular prognostic factors in survival remains controversial, resulting in difficulty in selecting patients for new targeted therapies. We assessed mortality rate and DTC-specific survival in Middle Eastern RAIR-DTC to identify prognostic factors associated with survival. Methods: This single center, retrospective study enrolled 268 patients with RAIRDTC. Mortality rate and DTC-specific survival were analyzed to identify prognostic factors related to survival. Univariate and multivariate analysis were performed using Cox proportional hazards model. Results: Of the 268 cases of RAIR-DTC, 40.3% (108/268) had absent
131 I uptake (either on diagnostic or post-therapy whole body scan), 15.3% (41/268) had progressive disease (PD) despite 131I, 7.5% (20/268) had persistent disease despite cumulative activity of I131 of >600 mCi and 36.9% (n=99/268) developed distant metastasis. On multivariate analysis, age (more than 45 years), presence of metastatic disease and tumors harboring telomerase reverse transcriptase (TERT) promoter mutations were independent prognostic factors for poor DTC-specific survival. Subjects were divided into 3 groups according to the number of risk factors; low risk (no risk factors); intermediate (≤ 2 risk factors); and high risk (all the 3 risk factors). Ten-year DTC-specific survival rates in low, intermediate and high-risk groups were 100.0%, 92.9% and 53.6%, respectively Conclusions: The contribution of age greater than 45 years to RAIR-DTC mortality is impactful. Older age, presence of distant metastasis and TERT mutations could be used as early predictors of RAIR-DTC cases. The identification of prognostic factors for poor survival in RAIR-DTC may improve the selection of patients for more personalized surveillance and therapeutic modalities. [ABSTRACT FROM AUTHOR]- Published
- 2024
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43. Causal relationship between gut microbiota and differentiated thyroid cancer: a two-sample Mendelian randomization study.
- Author
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Shaojun Hu, Chuangang Tang, Ling Wang, Fang Feng, Xiaoxin Li, Mingyu Sun, and Lijun Yao
- Subjects
GUT microbiome ,THYROID cancer ,GENOME-wide association studies ,ODDS ratio ,MYCOPLASMATALES ,EUBACTERIALES - Abstract
Background: The gut microbiota has been significantly associated with differentiated thyroid cancer (DTC). However, the causal relationship between the gut microbiota and DTC remains unexplored. Methods: Genome-wide association study (GWAS) summary databases were utilized to select exposures and outcomes. The Mendelian randomization (MR) method was employed to investigate the causal relationship between the gut microbiota and DTC. A sensitivity analysis was performed to assess the reliability of the findings. Results: Four bacterial traits were associated with the risk of DTC: Class Mollicutes [odds ratio (OR) = 10.953, 95% confidence interval (95% CI): 2.333-51.428, p = 0.002], Phylum Tenericutes (OR = 10.953, 95% CI: 2.333-51.428, p = 0.002), Genus Eggerthella (OR = 3.219, 95% CI: 1.033-10.024, p = 0.044), and Order Rhodospirillales (OR = 2.829, 95% CI: 1.096-7.299, p = 0.032). The large 95% CI range for the Class Mollicutes and the Phylum Tenericutes may be attributed to the small sample size. Additionally, four other bacterial traits were negatively associated with DTC: Genus Eubacterium fissicatena group (OR = 0.381, 95% CI: 0.148-0.979, p = 0.045), Genus Lachnospiraceae UCG008 (OR = 0.317, 95% CI: 0.125-0.801, p = 0.015), Genus Christensenellaceae R-7 group (OR = 0.134, 95% CI: 0.020-0.886, p = 0.037), and Genus Escherichia Shigella (OR = 0.170, 95% CI: 0.037-0.769, p = 0.021). Conclusion: These findings contribute to our understanding of the pathological mechanisms underlying DTC and provide novel insights for the clinical treatment of DTC. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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44. Prognostic value of postoperative anti-thyroglobulin antibody in patients with differentiated thyroid cancer.
- Author
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Yihan Zhao, Zhuanzhuan Mu, Dongquan Liang, Teng Zhang, Xin Zhang, Di Sun, Yuqing Sun, Jun Liang, and Yansong Lin
- Subjects
PROGRESSION-free survival ,THYROID cancer ,PROGNOSIS ,RECEIVER operating characteristic curves ,IODINE isotopes ,OVERALL survival - Abstract
Purpose: Postoperative thyroglobulin (Tg) generally serves as a biomarker to monitor the recurrence or persistence of differentiated thyroid cancer (DTC), whereas it constrains to interference from anti-thyroglobulin antibody (TgAb). This study aimed to determine the value of postoperative TgAb as a surrogate for monitoring tumor status in DTCs with positive TgAb after successful radioactive iodine (RAI) remnant ablation. Methods: We retrospectively enrolled DTC patients with positive (≥40 IU/mL, Roche) postoperative TgAb measurements. An index of TgAb change (ΔTgAb) was defined to describe the TgAb decrease rate. DTC status was defined as either no evidence of disease (NED) or persistent/recurrent disease (PRD). Univariate and multivariate binary logistic analyses were used to identify the independent risk factors of PRD. Receiver operating characteristic (ROC) curves were performed to determine the optimal cutoff values of each risk factor, and DeLong's test was conducted to compare their predictive powers. Kaplan-Meier curves were used to assess the impact of different TgAb trends in the first year on progression-free survival. Results: Of the 232 patients enrolled, the median diagnosis age was 34 years (range, 18-62 years), with a male-to-female ratio of 1:4.66 (41/191). Among them, after a median follow-up of 44 months (range, 4-128 months),183 (78.87%) patients were evaluated as NED, while the other 49 (21.12%) had either persistent (n = 25) or recurrent disease (n = 24). Multivariate regression showed that ΔTgAb (P < 0.001) and lymph node metastasis (LNM) rate (P = 0.009) were independently relevant to the presence of PRD, with optimal cutoff values of 47.0% and 35.1%, respectively. It is important to note that there is a high negative predictive value (96.93%) of ΔTgAb with the cutoff of 47.0%. DeLong's test showed that ΔTgAb alone and the combination of ΔTgAb and LNM rate were significantly greater than the isolated LNM rate (both P < 0.001) in predicting NED, while there was no statistical difference of the predictive power between ΔTgAb and the combination (P = 0.203). Additionally, patients with ΔTgAb >47.0% had longer progression-free survival than those with ΔTgAb =47.0% (not reached vs. 50 months, P < 0.001), and those with ΔTgAb >47.0% or negative conversion within the first year after RAI ablation had longer progression-free survival. Conclusion: Our study suggested that ΔTgAb could serve as a valuable indicator of disease status in DTC patients with positive TgAb. A ΔTgAb of >47.0% is conducive to identify those with NED and may help to obviate their overtreatment. The decrease rate and negative conversion of TgAb in the first year were good predictors of disease-free survival in patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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45. Diagnostic, Theranostic and Prognostic Value of Thyroglobulin in Thyroid Cancer.
- Author
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Giovanella, Luca, D'Aurizio, Federica, Petranović Ovčariček, Petra, and Görges, Rainer
- Subjects
- *
THYROID cancer , *PROGNOSIS , *THYROGLOBULIN , *TUMOR markers , *IODINE isotopes - Abstract
Thyroglobulin (Tg) is an iodinated glycoprotein, which is normally stored in the follicular colloid of the thyroid, being a substrate for thyroid hormone production. Since it is produced by well-differentiated thyroid cells, it is considered a reliable tumor marker for patients with differentiated thyroid carcinoma (DTC) during their follow-up after total thyroidectomy and radioiodine ablation. It is used to monitor residual disease and to detect recurrent disease. After total thyroid ablation, unstimulated highly sensitive Tg measurements are sufficiently accurate to avoid exogenous or endogenous thyrotropin (TSH) stimulation and provide accurate diagnostic and prognostic information in the great majority of DTC patients. Adopting sophisticated statistical analysis, i.e., decision tree models, the use of Tg before radioiodine theranostic administration was demonstrated to be useful in refining conventional, pathology-based risk stratification and providing personalized adjuvant or therapeutic radioiodine administrations. The follow-up of DTC patients aims to promptly identify patients with residual or recurrent disease following primary treatment. Our review paper covers the diagnostic, theranostic and prognostic value of thyroglobulin in DTC patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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46. A Prospective Cohort Study Exploring the Effect of Lenvatinib Planned Drug Holidays in Treatment of Differentiated Thyroid Cancer.
- Author
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Tahara, Makoto, Takami, Hiroshi, Ito, Yasuhiro, Okamoto, Takahiro, Sugitani, Iwao, Sugino, Kiminori, Takahashi, Shunji, Takeyama, Hiroshi, Tsutsui, Hidemitsu, Hara, Hisato, Mitsuma, Ayako, Yamashita, Hiroyuki, Ohashi, Yasuo, and Imai, Tsuneo
- Subjects
- *
STRUCTURED treatment interruption , *THYROID cancer , *ORAL drug administration , *LONGITUDINAL method , *COHORT analysis - Abstract
Background: Although lenvatinib is the preferred treatment for unresectable radioactive iodine-refractory differentiated thyroid cancer (RR-DTC), this agent exerts considerable toxicities, which can lead to frequent dose interruptions and modifications. The adoption of planned drug holidays has been recently suggested as one means of minimizing or avoiding these severe adverse events. Our retrospective study demonstrated that planned drug holidays appear to be a promising strategy for continuing of lenvatinib. However, the benefits of planned drug holidays in a prospective study have yet to be clarified. Here, we investigated the impact of planned drug holidays on clinical outcomes in patients treated with lenvatinib in the COLLECT study. Methods: In COLLECT, a prospective observational study, patients with RR-DTC were treated with lenvatinib in a real-world clinical setting. Lenvatinib was administered orally at a dose of 24 mg daily. Dose modification for toxicities was permitted. Furthermore, planned drug holidays were allowed to avoid severe or intolerable toxicities. The present post hoc analysis focused on evaluating the impact of planned drug holidays on clinical outcomes, including overall survival (OS), time to treatment failure (TTF), time to failure strategy (TFS), and progression-free survival (PFS), in patients in the COLLECT study who were treated with lenvatinib. Results: In total, 262 patients were included. Of the 253 patients evaluable for efficacy, 73 undertook a planned drug holiday at the discretion of the attending physician. OS, TTF, TFS, and PFS were significantly longer in patients who used a planned drug holiday than in those who did not. The planned drug holiday group demonstrated notable clinical outcomes, with a 1-year OS of 95.8% and a 1-year PFS of 94.5%. Moreover, planned drug holidays demonstrated a clinically meaningful advantage in clinical outcomes. The planned drug holiday group had a significantly longer duration of administration at a dose of ≥10 mg. Conclusions: Planned drug holidays for lenvatinib were associated with significantly improved clinical outcomes compared to daily oral administration. Further investigation of the optimal treatment schedule for lenvatinib is warranted. Clinical Trial Registration: UMIN000022243. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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47. Comparison of Bone Mineral Density and Trabecular Bone Score in Patients with and without Vertebral Fractures and Differentiated Thyroid Cancer with Long-Term Serum Thyrotrophin-Suppressed Therapy.
- Author
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Hawkins Carranza, Federico, Arroba, Cristina Martin-Arriscado, López Alvarez, María Begoña, Librizzi, Soledad, and Martínez Díaz Guerra, Guillermo
- Subjects
- *
BONE density , *LUMBAR vertebrae , *VERTEBRAL fractures , *SEROTHERAPY , *THYROID cancer , *BONE health - Abstract
Introduction: The study of BMD provides only partial information on bone health in patients undergoing TSH suppression therapy due to differentiated thyroid cancer (DTC). The trabecular bone score (TBS), a new parameter assessing bone microarchitecture, is proposed for studying bone in this context. This study aimed to analyze their long-term use in patients with DTC. Methods: Bone mineral density (BMD) was measured by dual X-ray densitometry (DXA) and TBS was assessed with iNsigth software (version 2.0, MediImaps, France) in 145 postmenopausal patients with DTC. Vertebral fractures (VFs) were identified using a semi-quantitative X-ray method. Results: The BMD at the end of this study did not differ from the initial measurement. However, the TBS decreased from 1.35 ± 0.1 to 1.27 ± 0.1 (p = 0.002). Increased levels of PTH, osteocalcin, and bone alkaline phosphatase (BAP) were observed, suggesting enhanced bone remodeling. There was an increase in the prevalence of osteoporosis and osteopenia (40.6% and 16.5% to 46.6% and 18.6%, respectively). The proportion of patients with partially degraded and totally degraded TBS increased from 31% and 15.1% to 48.9% and 24.8% by the end of this study. Among the 30 patients with VFs, there were no significant differences in age, body mass index (BMI), calcium intake, alcohol consumption, smoking, radioiodine, therapy, or thyroid parameters compared to those without VFs. The odds ratio for VFs increased with osteopenia (OR 2.63). Combining TBS with BMD did not improve discrimination. Conclusions: The TBS decreased while the BMD remained unchanged. The percentage of patients with osteoporosis and osteopenia, whether partially degraded or totally degraded, increased by the end of this study. The predominant discordance was found in partially degraded microarchitectures, with a higher proportion of osteopenic patients compared to those with normal or osteoporotic bone density. The AUC of the combination of TBS and BMD did not enhance discrimination. TBS, radioactive iodine therapy, and sedentary lifestyle emerged as the main distinguishing factors for DTC patients with VFs. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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48. The effect of COVID-19 pandemic restrictions on the management of differentiated thyroid cancer in Turkey: a single tertiary centre experience.
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Calapkulu, Murat, Sencar, Muhammed Erkam, Ozturk Unsal, Ilknur, Sakiz, Davut, Tekinyildiz, Merve, Ozbek, Mustafa, and Cakal, Erman
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THYROID cancer , *COVID-19 pandemic , *COVID-19 , *SARS-CoV-2 , *CANCER diagnosis , *DELAYED diagnosis - Abstract
Purpose: Many countries have implemented unprecedented health measures since the World Health Organisation declared the novel coronavirus disease 2019 (COVID-19) a global pandemic. These measures have resulted in delays in the diagnosis of differentiated thyroid cancer (DTC). However, there is limited data on the impact of restrictions imposed during the pandemic on DTC management. Thus, the aim of this study is to analyse the clinicopathological and follow-up data of DTC patients diagnosed before and during the COVID-19 outbreak. Methods: This retrospective study included 191 DTC patients that were diagnosed between December 2018 and June 2021. The patients were divided into two groups: patients diagnosed before (December 2018 to February 2020) and during (March 2020 to June 2021) the COVID-19 pandemic. The clinicopathological and follow-up data between the two groups were compared. Results: Similar preoperative cytology results were obtained from the two groups. No difference with regard to tumour size, lymphovascular invasion and extrathyroidal invasion was observed between the two groups. While the American Thyroid Association risk stratification was similar between the two groups, radioactive iodine (RAI) therapy was applied less during the COVID-19 period. Although RAI therapy was administered at a lower rate during the COVID-19 period, the recurrence rates among patients after two years of follow-up were similar to those during the pre-COVID-19 period. Conclusion: Although the COVID-19 pandemic restrictions during the pandemic period caused difficulties in the management of DTC patients, this did not negatively affect their prognosis. These findings can confirm the applicability of active surveillance in DTC patients and may help change the real-life treatment practices in selected low-risk DTC patients. [ABSTRACT FROM AUTHOR]
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- 2024
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49. Characterizing Genetic Alterations Related to Radioiodine Avidity in Metastatic Thyroid Cancer.
- Author
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Mu, Zhuanzhuan, Zhang, Xin, Sun, Di, Sun, Yuqing, Shi, Cong, Ju, Gaoda, Kai, Zhentian, Huang, Lisha, Chen, Libo, Liang, Jun, and Lin, Yansong
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THYROID cancer ,IODINE isotopes - Abstract
Context Patients with differentiated thyroid cancer (DTC) with distant metastasis (DM) are usually not recognized as radioactive iodine (RAI)-refractory DTC in a timely manner. The elucidation of genetic features related to RAI uptake patterns may shed light on the early recognition of RAI-refractory DTC. Objective This work aimed to elucidate the underlying molecular features behind different RAI uptake patterns. Methods A total of 214 patients with DM-DTC were retrospectively included in the analysis. RAI uptake patterns were defined as initially RAI refractory (I-RAIR) and initially RAI avid (I-RAIA) according to the first post-treatment scan, then I-RAIA was further divided into continually RAIA (C-RAIA), partly RAIR (P-RAIR), and gradually RAIR (G-RAIR) according to subsequent scans. The molecular subtype groups— BRAF
V600E mutated, RAS mutated, fusions, and others—were classified according to main driver genes status. Results BRAF , TERT promoter, and TP53 mutations are more frequently detected in the I-RAIR pattern while RET fusions and RAS mutations are more frequent in the I-RAIA pattern. A late-hit mutation including TERT , TP53 , or PIK3CA is more common in I-RAIR than that in I-RAIA (50.0% vs 26.9%, P =.001), particularly for those with RAS mutations in the I-RAIR group, always accompanied by TERT promoter. Isolated RET fusions accounts for 10% of I-RAIR. When compared among driver gene groups, BRAFV600E -mutated tumors have a higher rate of the I-RAIR pattern (64.4%) than RAS -mutated (4.5%, P <.001) and fusion-positive (20.7%, P <.001) tumors. In I-RAIA subgroups, BRAFV600E -mutated tumors have lower prevalence of the C-RAIA pattern than those with RAS mutation or fusions. Conclusion Patients with the I-RAIR pattern predominantly featured mutations of the BRAF and/or TERT promoter, of which RAS mutations were usually accompanied by late-hit mutations, while fusions mostly occurred alone. [ABSTRACT FROM AUTHOR]- Published
- 2024
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50. Real-world treatment patterns and clinical outcomes in patients with radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) treated with first line lenvatinib monotherapy in the United States.
- Author
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Worden, Francis, Rajkovic-Hooley, Olivera, Reynolds, Neil, Milligan, Gary, and Zhang, Jingchuan
- Abstract
Purpose: Lenvatinib was approved for the treatment of patients with radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) in the United States (US) in 2015. The main objective of the current study was to assess real-world clinical effectiveness in RAI-R DTC patients treated with first line lenvatinib monotherapy in the US. Methods: A retrospective chart review was conducted in RAI-R DTC patients who initiated lenvatinib monotherapy as first line treatment between February 2015 and September 2020. Anonymized data were abstracted by prescribing physicians from individual patient's electronic health records. Clinical outcomes included provider-reported real-world best overall response (rwBOR), real-world progression-free survival (rwPFS), and overall survival (OS). Time-to-event endpoints were assessed using Kaplan–Meier methods. Results: Our study included 308 RAI-R DTC patients treated with first line lenvatinib. At lenvatinib initiation, patients' median age was 60 years, 51.6% were female, and 26.0% of patients had an ECOG performance score of ≥2. Over the follow-up period, 32.5% of patients discontinued first line lenvatinib permanently, with others remaining on treatment. The median duration of lenvatinib therapy was 17.5 months overall. Provider-reported rwBOR (complete or partial response) to lenvatinib was 72.4%. Median rwPFS was 49.0 months. Estimated rwPFS rates at 24 and 48 months were 68.5% and 55.0%, respectively. Estimated OS rates at 24 and 72 months were 78.4% and 57.0%, respectively; median OS was not reached. Conclusion: The current study reinforces the clinical effectiveness of first line lenvatinib as standard of care in patients with RAI-R DTC in real-world clinical practice in the US. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
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