Updates on the Management of Thyroid Cancer

Araque, Katherine A; Gubbi, Sriram; Kłubo-Gwieździńska, Joanna

doi:10.1055/a-1089-7870

Cited by 112 publications

(113 citation statements)

References 110 publications

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“…Some studies reported that age ≥70 years old was an indicator of poor survival for ATC patients (Onoda et al, 2020;Sugitani et al, 2012). Some studies reported that people younger than 60 years old had superior prognosis (Araque, Gubbi & Klubo-Gwiezdzinska, 2020;Roche et al, 2018). Taken these into consideration, we divided patients into <65 and ≥65 years old groups.…”

Section: Covariatesmentioning

confidence: 99%

Development and validation of a prognostic nomogram to predict overall survival and cancer-specific survival for patients with anaplastic thyroid carcinoma

Gui¹,

Zhu²,

Lu³

et al. 2020

PeerJ

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Background Anaplastic thyroid carcinoma (ATC) is a rare malignant tumor with a poor prognosis. However, there is no useful clinical prognostic predictive tool for ATC so far. Our study identified risk factors for survival of ATC and created a reliable nomogram to predict overall survival (OS) and cancer-specific survival (CSS) of patients with ATC. Methods A total of 1,404 cases of ATC diagnosed between 1983 and 2013 were extracted from on the Surveillance, Epidemiology and End Results database based on our inclusion criteria. OS and CSS were compared among patients between each variable by Kaplan–Meier methods. The Cox proportional hazards model was used to evaluate multiple prognostic factors and obtain independent predictors. All independent risk factors were included to build nomograms, whose accuracy and practicability were tested by concordance index (C-index), calibration curves, ROC curves, DCA, net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results Historic stage, tumor size, surgery and radiotherapy were independent risk factors associated with ATC according to multivariate Cox regression analysis of OS. However, gender was also an important prognostic predictor in CSS besides the factors mentioned above. These characteristics were included in the nomograms predicting OS and CSS of patients with ATC. The nomograms predicting OS and CSS performed well with a C-index of 0.765 and 0.773. ROC curves, DCA, NRI and IDI suggested that the nomogram was superior to TNM staging and age. Conclusion The proposed nomogram is a reliable tool based on the prediction of OS and CSS for patients with ATC. Such a predictive tool can help to predict the survival of the patients.

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Section: Covariatesmentioning

confidence: 99%

Development and validation of a prognostic nomogram to predict overall survival and cancer-specific survival for patients with anaplastic thyroid carcinoma

Gui¹,

Zhu²,

Lu³

et al. 2020

PeerJ

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“…In this subgroup of DTC patients, the 10-year survival rate is less than 20% [2]. In medullary thyroid carcinomas (MTCs) distant metastases are present at diagnosis in 7-23% of patients and represent the main cause of cancer-related death with a 10-year survival rate disease ≤40% compared to a 10-year overall survival of 75% observed in unselected MTC patients [3,4]. Four multikinase inhibitors (vandetanib, cabozantinib, sorafenib and lenvatinib), all targeting the vascular endothelial growth factor receptor (VEGFR), have obtained regulatory approval for advanced thyroid cancer as a result of significant improvement in progression free survival (PFS) demonstrated in phase III trials [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Improvement of Overall Survival Using TKIs as Salvage Therapy in Advanced Thyroid Carcinoma: Real-Life Data on a Single Center Experience

Brilli

Dalmiglio

Pilli

et al. 2021

JCM

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Background: Tyrosine kinase inhibitors (TKIs) have improved progression-free survival in patients with advanced thyroid cancer. So far, few studies have investigated the efficacy of TKIs in a second-line setting. The purpose of our study was to explore the salvage therapy efficacy in patients with advanced thyroid cancer. Methods: We retrospectively evaluated 63 patients with progressive advanced thyroid carcinoma treated with TKIs divided into a Study group (23 patients) treated with salvage therapy, and a Control group (40 patients) treated with only one TKI. Results: Similar clinical benefits (stable disease + partial response) and progression free survival between the first and the second line TKI were observed in the Study group (p > 0.99 and p = 0.5, respectively). Median overall survival (OS) was 67.7 months in the Study group and 22.6 months in the Control group (HR 2.46; 95% CI 1.34–4.52, p = 0.004). After stratifying the whole population by age (<65 and ≥65 years), OS was significantly different (p < 0.001) with the best survival curve in younger patients, treated with salvage therapy and the worst in older subjects, treated with only one TKI. Conclusions: Salvage therapy showed a significant improvement of OS in patients with advanced thyroid cancer who experienced disease progression during prior TKI therapies.

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“…Therefore, the NCCN guidelines for MTC management suggest that pembrolizumab should be considered in patients with symptomatic, progressive MTC with high TMB (≥10 mutations/megabase) [ 6 ]. Pembrolizumab (NCT03072160, NCT-02721732), nivolumab (NCT03246958), and ipilimumab (NCT-03246958) are currently being evaluated in phase 2 trials for the treatment of recurrent or metastatic MTC [ 41 ].…”

Section: Management In Persistent or Recurrent Mtcmentioning

confidence: 99%

Current Guidelines for Management of Medullary Thyroid Carcinoma

Kim

2021

Endocrinol Metab

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Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor originating from the parafollicular cells. The diagnostic and therapeutic strategies for the condition are different from those used for well-differentiated thyroid cancer. Since the 2015 American Thyroid Association guidelines for the diagnosis and treatment of MTC, the latest, including the National Comprehensive Cancer Network and European Association for Medical Oncology guidelines have been updated to reflect several recent advances in the management of MTC. Advances in molecular diagnosis and postoperative risk stratification systems have led to individualized treatment and follow-up strategies. Multi-kinase inhibitors, such as vandetanib and cabozantinib, can prolong disease progression-free survival with favorable adverse effects. In addition, potent selective rearranged during transfection (RET) inhibitors (selpercatinib and pralsetinib) have shown a promising efficacy in recent clinical trials. This review summarizes the management of MTC in recent guidelines focused on sporadic MTC.

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Updates on the Management of Thyroid Cancer

Cited by 112 publications

References 110 publications

Development and validation of a prognostic nomogram to predict overall survival and cancer-specific survival for patients with anaplastic thyroid carcinoma

Development and validation of a prognostic nomogram to predict overall survival and cancer-specific survival for patients with anaplastic thyroid carcinoma

Improvement of Overall Survival Using TKIs as Salvage Therapy in Advanced Thyroid Carcinoma: Real-Life Data on a Single Center Experience

Current Guidelines for Management of Medullary Thyroid Carcinoma

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