Combination Immunotherapy and TKI in Metastatic Refractory Thyroid Cancer, a Case Series

Porter, Ashleigh; Zeh, Audrey; Cohen, Ezra E.W.; Chai-Ho, Wanxing; Wong, Deborah Jean Lee

doi:10.1016/j.ijrobp.2019.11.112

Cited by 2 publications

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“…The utility of combining TKIs and immunotherapeutic agents is currently an area of active investigation. Several published case series in TC highlight the potential for combination targeted therapy with checkpoint inhibition to confer prolonged tumor control, even in patients who have progressed on prior targeted therapy ( 32 , 33 ). Eight patients with metastatic ATC or DTC were treated with lenvatinib (24 mg/kg daily) in combination with pembrolizumab (200 mg every 3 weeks).…”

Section: Combination Therapiesmentioning

confidence: 99%

Perspectives on the Treatment of Advanced Thyroid Cancer: Approved Therapies, Resistance Mechanisms, and Future Directions

Porter

Wong

2021

Front. Oncol.

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For differentiated thyroid cancer (DTC), systemic therapy with radioactive iodine (RAI) is utilized for radiosensitive disease, while for radioiodine refractory (RAIR) disease, current standard of care is treatment with multikinase tyrosine kinase inhibitors (TKI). For BRAF-mutant DTC or anaplastic thyroid cancer (ATC), treatment with inhibitors targeting BRAF and MEK are important advances. RET-inhibitors for RET-mutated medullary thyroid cancer (MTC) recently have been FDA-approved for metastatic disease. Nevertheless, treatment of thyroid cancer resistant to current systemic therapies remains an important area of need. Resistance mechanisms are being elucidated, and novel therapies including combinations of BRAF and MEK inhibitors with RAI or other targeted therapies or TKIs combined with checkpoint inhibition are current areas of exploration.

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Section: Combination Therapiesmentioning

confidence: 99%

Perspectives on the Treatment of Advanced Thyroid Cancer: Approved Therapies, Resistance Mechanisms, and Future Directions

Porter

Wong

2021

Front. Oncol.

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“…The synergistic effect of the combination of checkpoint blockade and KIs in metastatic refractory thyroid cancer was reported in a single-institution case series ( Porter et al 2020 ). A single-arm phase 2 trial of the combination of lenvatinib (20 mg) and pembrolizumab in patients with RAI-R DTC with PD within 14 months was reported ( Haugen et al 2020 ).…”

Section: Combination Of Kinase Inhibitors With Immune Checkpoint Inhi...mentioning

confidence: 97%

Kinase inhibitors in thyroid cancers

et al. 2023

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Objective: The treatment landscape for thyroid cancers has changed rapidly with the availability of kinase inhibitors against VEGFR, BRAF, MEK, NTRK, and RET. We provide an up-to-date review of the role of kinase inhibitors in thyroid cancer and discuss upcoming trials. Design and Methods: A comprehensive review of the available literature describing kinase inhibitors in thyroid cancer was performed. Results and Conclusions: Kinase inhibitors have become the standard of care for patients with metastatic radioactive iodine-refractory thyroid cancer. Short-term treatment can re-sensitize differentiated thyroid cancer to radioactive iodine, thereby improving outcomes and sparing toxicities associated with long-term use of kinase inhibitors. The approval of cabozantinib as salvage therapy for progressive radioactive iodine-refractory differentiated thyroid cancer following failure with sorafenib or lenvatinib adds to the available armamentarium of active agents. Vandetanib and cabozantinib have become mainstay treatments for metastatic medullary thyroid cancer regardless of RET mutation status. Selpercatinib and pralsetinib, potent and selective receptor kinase inhibitors with activity against RET have revolutionized the treatment paradigm for medullary thyroid cancers and other cancers with driver mutations in RET. Dabrafenib plus trametinib for BRAF mutated anaplastic thyroid cancer provides an effective treatment option for this aggressive cancer with a dismal prognosis. In order to design the next generation of agents for thyroid cancer, future efforts will need to focus on developing a better understanding of the mechanisms of resistance to kinase inhibition including bypass signaling and escape mutations.

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Combination Immunotherapy and TKI in Metastatic Refractory Thyroid Cancer, a Case Series

Cited by 2 publications

References 0 publications

Perspectives on the Treatment of Advanced Thyroid Cancer: Approved Therapies, Resistance Mechanisms, and Future Directions

Perspectives on the Treatment of Advanced Thyroid Cancer: Approved Therapies, Resistance Mechanisms, and Future Directions

Kinase inhibitors in thyroid cancers

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