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ESMO 2020: Predicting Response to Radioiodine Treatment in Thyroid Cancer With Bone Metastasis

By: Julia Fiederlein
Posted: Friday, October 2, 2020

According to Arnaud Jannin, MD, of the Centre Hospitalier Régional Universitaire de Lille, France, and colleagues, the uptake of fluorodeoxyglucose (FDG) into bone metastases may be a prognostic factor for a total radioiodine response as well as for overall survival in patients with differentiated thyroid cancer. The results of this retrospective TUTHYREF study were presented during the European Society for Medical Oncology (ESMO) Virtual Congress 2020 (Abstract 1921P).

“Bone metastases are frequent in differentiated thyroid cancer, affecting the skeleton at various extents, impacting negatively quality of life, being the leading cause of differentiated thyroid cancer–related morbidity and death,” the investigators remarked. “FDG-PET/CT should be performed as soon as the bone metastases diagnosis.”

A total of 178 patients with differentiated thyroid cancer and newly diagnosed bone metastases were enrolled. Of this study population, 145 patients with non–radioiodine-refractory disease were evaluated for a total radioiodine response. The investigators defined a total radioiodine response as the complete resolution of radioiodine uptake in the absence of morphologic progression of bone metastases.

The median overall survival time from the diagnosis of bone metastases was 57 months. The overall survival rates for patients with radioiodine uptake at 5 and 10 years from the detection of bone metastases were 56.5% and 15.3%, respectively. For patients without any significant radioiodine uptake, the overall survival rates were 28.6% and 4.8%, respectively. Radioiodine refractory status (P = .0264), uptake of FDG into bone metastases (P = .0204), and a stage T4 disease (P = .113) seemed to significantly reduce overall survival. Of the patients with non–radioiodine-refractory disease, 31.7% achieved a total radioiodine response. Patients without extraskeletal metastasis (P = .005) and absence of FDG uptake into bone metastases (P = .0236) seemed to have a greater chance of achieving a total radioiodine response.

Disclosure: The study authors reported no conflicts of interest.

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