Thyroid Cancer Coverage from Every Angle

AACR 2021: Is COX-2 Expression Prognostic in BRAF-Mutated Papillary Thyroid Cancer?

By: Vanessa A. Carter, BS
Posted: Thursday, April 29, 2021

Rong Bu, MD, PhD, of King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, and colleagues conducted a study to evaluate cyclooxygenase-2 (COX-2) expression in papillary thyroid carcinoma, as the COX-2-prostaglandin E2 (PGE2) pathway appears to be involved in carcinogenesis with BRAF mutations. Presented during the virtual edition of the American Association for Cancer Research (AACR) Annual Meeting 2021, their research demonstrated a significant association between COX-2 expression and poor disease-free survival in tumors with BRAF mutations (Abstract 729).

“Our data suggest the potential therapeutic role of COX-2 inhibition in patients with BRAF-mutated papillary thyroid cancer,” the researchers concluded.

A large number of Middle Eastern patients with papillary thyroid carcinoma were enrolled in this study. Sanger sequencing was used to perform BRAF mutation analysis, and a tissue array evaluated the immunohistochemistry of COX-2 expression. 

Overexpression of COX-2 was identified in 43.2% of cases (567 of 1,314). It was significantly correlated with poor prognostic markers such as higher tumor stage, extrathyroidal tension, and lymph node metastasis. In addition, COX-2 expression also appeared to be an independent predictor of poor disease-free survival. The association of disease-free survival with COX-2 expression varied in the study depending on BRAF mutation status.

In BRAF-mutant disease, COX-2 overexpression was associated with poor disease-free survival, but this was not the case for BRAF wild-type papillary thyroid carcinomas. The multivariate adjusted hazard ratio for tumors that overexpressed COX-2 and demonstrated BRAF mutations was 2.10. These data show that COX-2 seems to play a role in the prognosis of patients with papillary thyroid cancer.

Disclosure: The study authors reported no conflicts of interest.


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