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Are Personalized Therapies Sparking Improvement in Survival in Anaplastic Thyroid Cancer?

By: Celeste L. Dixon
Posted: Thursday, August 27, 2020

Overall survival rates for patients with anaplastic thyroid carcinoma appear to be on the rise with the recent and emerging use of targeted therapy, immunotherapy, surgery, and radiation therapy, according to a team of authors from The University of Texas MD Anderson Cancer Center in Houston. Senior author Mark Zafereo, MD, and colleagues used a retrospective cohort study to examine the outcomes of 479 patients with this disease treated at their institution between 2000 and 2019. Although the median overall survival from the time of diagnosis has historically been about 4 months, the 1-year and 2-year survival rates for the patients treated from 2017 to 2019 were 59% and 42%, respectively. These study findings were published in JAMA Oncology.

“Regardless of disease stage, anaplastic thyroid carcinoma may be effectively treated with highly specialized molecular-based personalized therapies, and surgery when appropriate,” the team stated.

Of the nearly 500 patients included in the single-institution cohort study, 11% had stage IVA disease, 36% had stage IVB disease, and 53% had stage IVC disease at presentation. They were about evenly divided by sex, and their median age was 65 years.

The hazard ratio for overall survival at 1 and 2 years was 0.50 for patients in the 2017–2019 group compared with those in the 2000–2013 group (P  < .001). For the latter group, the 1- and 2-year overall survival rates were 35% and 18%, respectively.

Factors particularly associated with improved overall survival, explained Dr. Zafereo and co-investigators, included targeted therapy (P < .001), the addition of immunotherapy to targeted therapy (P = .03), and surgery after neoadjuvant BRAF-directed therapy (P = .02). In fact, 20 patients treated with the last regimen had a 1-year survival rate of 94%, with a median follow-up of 1.2 years.

Disclosure: The study authors’ disclosure information can be found at jamanetwork.com.

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