2013
DOI: 10.1210/jc.2012-3933
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Clinical Outcomes and Molecular Profile of Differentiated Thyroid Cancers With Radioiodine-Avid Distant Metastases

Abstract: Background: Radioiodine (RAI) remains the mainstay of therapy for RAI-avid (RAIA) distant metastatic thyroid carcinoma. We previously demonstrated that RAI-refractory distant metastatic thyroid cancers commonly harbor BRAF mutations. However, the molecular profile of RAIA metastatic thyroid cancer is unknown. Here we describe the mutational profile of thyroid tumors from follicular cell-derived cancer (FCDTC) patients presenting with RAIA distant metastases. In addition, we aimed to correlate clinical outcomes… Show more

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Cited by 118 publications
(84 citation statements)
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“…BRAF mutation analysis offers a very low positive predictive value (28%) and a high negative predictive value (87%) for disease recurrence, therefore suggesting that BRAF mutation analysis should be used with caution in the clinical management of PTC (46). Positivity for a BRAF mutation also has been associated with the loss of radioactive iodine avidity of recurrent PTC (47)(48)(49)(50). RAS mutations are associated with a thyroid neoplasm with a follicular pattern, and have also been reported in poorly DTC (51).…”
Section: Biologic Factors Impacting Virulence and Likelihood For Progmentioning
confidence: 99%
“…BRAF mutation analysis offers a very low positive predictive value (28%) and a high negative predictive value (87%) for disease recurrence, therefore suggesting that BRAF mutation analysis should be used with caution in the clinical management of PTC (46). Positivity for a BRAF mutation also has been associated with the loss of radioactive iodine avidity of recurrent PTC (47)(48)(49)(50). RAS mutations are associated with a thyroid neoplasm with a follicular pattern, and have also been reported in poorly DTC (51).…”
Section: Biologic Factors Impacting Virulence and Likelihood For Progmentioning
confidence: 99%
“…Tumors displaying this mutation take a more aggressive course and store radioactive iodine to a markedly lesser extent, even though they are often positive in fluorodeoxyglucose positron emission tomography (FDG-PET) (Figure). In contrast, it seems that tumors with radio-iodine-positive metastases more often display a rat sarcoma proto-oncogene (RAS) mutation (24). Data on the frequency of radioactive iodine resistance are highly variable, as the findings depend to a large extent on the group of patients studied and on the particular diagnostic tests that are carried out.…”
Section: Radioactive Iodine Resistancementioning
confidence: 99%
“…For example, a large study of patients with metastatic thyroid cancer found that patients who have iodine avid and responsive metastatic thyroid cancer have a 10-year survival rate of 90%, while those with I-131 non-avid thyroid cancer have a 10-year survival rate of only 10% (Durante, et al 2006). A more recent study demonstrates the overall lack of oncologic benefit in the majority of patients treated with I-131 for distant metastases (Sabra, et al 2013). These studies emphasize that I-131 therapy when administered as a solitary therapy is rarely curative in patients with thyroid cancer.…”
Section: Introductionmentioning
confidence: 99%