Spanish consensus for the management of patients with anaplastic cell thyroid carcinoma

Abstract

Anaplastic thyroid cancer (ATC) is the most aggressive solid tumor and almost uniformly lethal in humans. The Boards of the Thyroid Cancer Group of the Spanish Society of Endocrinology and Nutrition and the Grupo Español de Enfermedades Huérfanas e Infrecuentes of the Spanish Society of Oncology requested that an independent task force draft a more comprehensive consensus statement regarding ATC. All relevant literature was reviewed, including serial PubMed searches together with additional articles. This is the first, comprehensive Spanish consensus statement for ATC and includes the characteristics, diagnosis, initial evaluation, treatment goals, recommendations and modalities for locoregional and advanced disease, palliative care options, surveillance, and long-term monitoring. Newer systemic therapies are being investigated, but more effective combinations are needed to improve patient outcomes. Though more aggressive radiotherapy has reduced locoregional recurrences, median overall survival has not improved in more than 50 years.

Anaplastic Thyroid Carcinoma: An Update

“…However, because hyperfractionation or accelerated regimens require more intensive resources and the data supporting their efficacy are scarce, recent studies have used regimens close to those used in EBRT of other head and neck cancers in 2 Gy per fraction [ 60 , 78 , 86 , 87 , 88 , 89 ]. In recent guidelines from the Italian Society of Radiation Oncology (AIRO) and Spanish Thyroid Group, bifractionation and standard fractionations are listed as two possible EBRT options, whereas hyperfractionation is discouraged in ESMO guidelines [ 3 , 90 , 91 ]. ATA guidelines recommend standard fractionation but do not discourage hyperfractionation [ 2 ].…”

The emerging function and clinical significance of circRNAs in Thyroid Cancer and Autoimmune Thyroid Diseases

“…Drug resistance is a prominent problem associated with the treatment of thyroid tumors, especially anaplastic thyroid carcinoma (ATC) [104]. Due to the undifferentiated phenotype and aggressive nature of ATC, resistance to conventional treatments such as radiotherapy and chemotherapy, including resistance to cisplatin, is observed often [105,106]. Therefore, patients with ATC tend to have a very poor prognosis.…”

Circular RNA EIF6 (Hsa_circ_0060060) sponges miR-144-3p to promote the cisplatin-resistance of human thyroid carcinoma cells by autophagy regulation

“…Although patients’ condition had some improvements by using those therapies, some patients did not respond to radioiodine (RAI) therapy [5] and occurred drug-resistance, especially in patients with ATC. Due to the undifferentiated phenotype and its aggressive nature of ATC, resistance to conventional treatments such as radiotherapy and chemotherapy, was often observed in the patients with ATC [6], including cisplatin-resistance [7]. Therefore, the patients with ATC have a very poor prognosis.…”