Neoadjuvant BRAF- and immune- directed therapy for anaplastic thyroid carcinoma.

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Neoadjuvant BRAF- and immune- directed therapy for anaplastic thyroid carcinoma.

Thyroid. 2018 May 10;:

Authors: Cabanillas M, Ferrarotto R, Garden A, Ahmed S, Busaidy N, Dadu R, Williams MD, Skinner H, Gunn B, Grosu H, Iyer PC, Hofmann MC, Zafereo M

Abstract
Anaplastic thyroid cancer (ATC) is a devastating disease with a dismal prognosis. Patients who have disease confined to the thyroid and who are able to undergo complete surgery and chemoradiation stand the best chance for survival. Unfortunately, nearly 50% of patients at diagnosis have distant metastases at diagnosis and most present with locally advanced, unresectable tumors. Nevertheless, BRAF-mutated ATC patients represent a subset of cases who can benefit from a combination therapy with BRAF and /MEK inhibitors. We hereby present a patient with end-stage, locally advanced, unresectable ATC who was treated with this combination. Immunotherapy with pembrolizumab was added at the first sign of progression after which he achieved a partial response to therapy, enabling us to undertake a complete surgical resection followed by post-operative chemoradiation. This novel neoadjuvant approach to BRAF-mutated ATC should be studied in further in clinical trials.

PMID: 29742974 [PubMed - as supplied by publisher]

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