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Esmati E, Aleyasin A, Ghalehtaki R, Jafari F, Farhan F, Aghili M, Haddad P, Kazemian A. The role of external beam radiation therapy in the management of thyroid carcinomas: A retrospective study in Iran Cancer Institute. Cancer Rep (Hoboken) 2022; 6:e1652. [PMID: 35691611 PMCID: PMC9875639 DOI: 10.1002/cnr2.1652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Thyroid cancers are histologically classified into three types; differentiated thyroid carcinoma (DTC), medullary thyroid carcinoma (MTC), and anaplastic thyroid carcinoma (ATC). Among the several therapeutic strategies for treatment and management of thyroid cancer, surgical resection in combination with radioactive iodine therapy (RAI) is indicated for moderate to high-risk differentiated thyroid cancer (DTC) patients- according to current guidelines. However, external radiation therapy (EBRT) can be a viable alternative treatment option for these patients and scarce evidence is available regarding the efficacy and effectiveness of EBRT on thyroid cancer. AIM This study aims at evaluating the role of EBRT in the management of thyroid carcinomas. METHODS AND RESULTS In this retrospective cohort study, the records of 59 patients with thyroid cancer were accessed who were treated by EBRT from 2008 to 2016. The indications for EBRT included unresectable primary (definitive) or loco-regional recurrences (salvage) not suitable for RAI, palliation for local disease or metastatic foci (palliative), and the adjuvant treatment for suspected residual disease following resection. Progression-free survival (PFS) and overall survival (OS) were calculated for different types of cancer. PFS was measured from the start of EBRT to the last uneventful follow-up, recurrence, or death. Kaplan-Meier model was used for the survival analysis. Fifty-nine patients were evaluated. The histopathology of the tumors was differentiated and poorly-differentiated, medullary and anaplastic thyroid carcinomas in 22 and 6, 15 and 16 patients, respectively. Twenty-seven patients received external beam radiotherapy (EBRT) as adjuvant therapy and 18 of the cases as palliative therapy while the remaining received salvage or definitive primary EBRT. The stage of patients' cancer was as follows: stage II in 3 and III in 1, IVA in 18 and IVB in 18 and IVC in 19. Stage-based median overall survival was 26 months for IVA, 44 for IVB, and 29 for IVC. The median PFS was 18, 22 and 21 months for stages IVA, IVB and IVC, respectively. CONCLUSION Based on our findings, EBRT may still play a role in the management of patients with thyroid carcinoma and should be considered in the armamentarium against thyroid cancers.
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Affiliation(s)
- Ebrahim Esmati
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran,Radiation Oncology Research Center (RORC), Cancer Research InstituteTehran University of Medical SciencesTehranIran
| | - Alireza Aleyasin
- School of MedicineTehran University of Medical SciencesTehranIran
| | - Reza Ghalehtaki
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran,Radiation Oncology Research Center (RORC), Cancer Research InstituteTehran University of Medical SciencesTehranIran
| | - Fatemeh Jafari
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran,Radiation Oncology Research Center (RORC), Cancer Research InstituteTehran University of Medical SciencesTehranIran
| | - Farshid Farhan
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran,Radiation Oncology Research Center (RORC), Cancer Research InstituteTehran University of Medical SciencesTehranIran
| | - Mahdi Aghili
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran,Radiation Oncology Research Center (RORC), Cancer Research InstituteTehran University of Medical SciencesTehranIran
| | - Peiman Haddad
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran,Radiation Oncology Research Center (RORC), Cancer Research InstituteTehran University of Medical SciencesTehranIran
| | - Ali Kazemian
- Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran,Radiation Oncology Research Center (RORC), Cancer Research InstituteTehran University of Medical SciencesTehranIran
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Hamidi AA, Taghehchian N, Basirat Z, Zangouei AS, Moghbeli M. MicroRNAs as the critical regulators of cell migration and invasion in thyroid cancer. Biomark Res 2022; 10:40. [PMID: 35659780 PMCID: PMC9167543 DOI: 10.1186/s40364-022-00382-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/07/2022] [Indexed: 12/14/2022] Open
Abstract
Thyroid cancer (TC) is one of the most frequent endocrine malignancies that is more common among females. Tumor recurrence is one of the most important clinical manifestations in differentiated TC which is associated with different factors including age, tumor size, and histological features. Various molecular processes such as genetic or epigenetic modifications and non-coding RNAs are also involved in TC progression and metastasis. The epithelial-to-mesenchymal transition (EMT) is an important biological process during tumor invasion and migration that affects the initiation and transformation of early-stage tumors into invasive malignancies. A combination of transcription factors, growth factors, signaling pathways, and epigenetic regulations affect the thyroid cell migration and EMT process. MicroRNAs (miRNAs) are important molecular factors involved in tumor metastasis by regulation of EMT-activating signaling pathways. Various miRNAs are involved in the signaling pathways associated with TC metastasis which can be used as diagnostic and therapeutic biomarkers. Since, the miRNAs are sensitive, specific, and non-invasive, they can be suggested as efficient and optimal biomarkers of tumor invasion and metastasis. In the present review, we have summarized all of the miRNAs which have been significantly involved in thyroid tumor cells migration and invasion. We also categorized all of the reported miRNAs based on their cellular processes to clarify the molecular role of miRNAs during thyroid tumor cell migration and invasion. This review paves the way of introducing a non-invasive diagnostic and prognostic panel of miRNAs in aggressive and metastatic TC patients.
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Affiliation(s)
- Amir Abbas Hamidi
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negin Taghehchian
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Basirat
- Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Sadra Zangouei
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Meysam Moghbeli
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Maniakas A, Zafereo M, Cabanillas ME. Anaplastic Thyroid Cancer: New Horizons and Challenges. Endocrinol Metab Clin North Am 2022; 51:391-401. [PMID: 35662448 DOI: 10.1016/j.ecl.2021.11.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Anaplastic thyroid cancer (ATC) remains one of the most aggressive and deadliest malignancies. Traditionally, treatment consisted of cytotoxic chemotherapy and radiation therapy, with or without surgery, although a large proportion of patients were often directed toward palliative/hospice care. In the past decade, significant advances have been made through the advent of targeted therapies and immunotherapy. For patients with targetable disease and considerable treatment response, surgery and other multidisciplinary adjuvant therapies can now be considered. Overall, the era of untreatable ATC is progressively being replaced by highly personalized multidisciplinary therapies, actively shifting the treatment pendulum of this disease.
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Affiliation(s)
- Anastasios Maniakas
- Division of Otolaryngology-Head and Neck Surgery, Hôpital Maisonneuve-Rosemont, Université de Montréal, 5415 Boul, Assomption, Montreal, QC H1T 2M4, Canada; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler Road, Unit 1465, Houston, TX 77030, USA
| | - Mark Zafereo
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler Road, Unit 1465, Houston, TX 77030, USA
| | - Maria E Cabanillas
- Department of Endocrine Neoplasia and Hormonal Disorders, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler Road, Unit 1461, Houston, TX 77030, USA.
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Mackay RP, Weinberger PM, Copland JA, Mahdavian E, Xu Q. YM155 Induces DNA Damage and Cell Death in Anaplastic Thyroid Cancer Cells by Inhibiting DNA Topoisomerase IIα at the ATP-Binding Site. Mol Cancer Ther 2022; 21:925-935. [PMID: 35405742 PMCID: PMC9167740 DOI: 10.1158/1535-7163.mct-21-0619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/10/2021] [Accepted: 04/01/2022] [Indexed: 11/16/2022]
Abstract
Anaplastic thyroid cancer (ATC) is among the most aggressive of human cancers, and currently there are few effective treatments for most patients. YM155, first identified as a survivin inhibitor, was highlighted in a high-throughput screen performed by the National Cancer Institute, killing ATC cells in vitro and in vivo. However, there was no association between survivin expression and response to YM155 in clinical trials, and YM155 has been mostly abandoned for development despite favorable pharmacokinetic and toxicity profiles. Currently, alternative mechanisms are being explored for YM155 by a number of groups. In this study, ATC patient samples show overexpression of topoisomerase Top2α compared with benign thyroid samples and to differentiated thyroid cancers. ATC cell lines that overexpress Top2α are more sensitive to YM155. We created a YM155-resistant cell line, which shows decreased expression of Top2α and is resensitized with Top2α overexpression. Molecular modeling predicts binding for YM155 in the Top2α ATP-binding site and identifies key amino acids for YM155-Top2α interaction. A Top2α mutant abrogates the effect of YM155, confirming the contribution of Top2α to YM155 mechanism of action. Our results suggest a novel mechanism of action for YM155 and may represent a new therapeutic approach for the treatment of ATC.
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Affiliation(s)
- Ryan P. Mackay
- Department of Otolaryngology-Head & Neck Surgery, Louisiana State University Health Sciences Center – Shreveport, Shreveport, LA, United States
- Department of Molecular & Cellular Physiology, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, United States
| | - Paul M. Weinberger
- Department of Otolaryngology-Head & Neck Surgery, Louisiana State University Health Sciences Center – Shreveport, Shreveport, LA, United States
- Department of Molecular & Cellular Physiology, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, United States
| | - John A. Copland
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, United States
| | - Elahe Mahdavian
- Department of Biological Sciences, Louisiana State University in Shreveport, Shreveport, LA, United States
| | - Qinqin Xu
- Department of Otolaryngology-Head & Neck Surgery, Louisiana State University Health Sciences Center – Shreveport, Shreveport, LA, United States
- Department of Molecular & Cellular Physiology, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, United States
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Abstract
Thyroid disease affects an estimated 20 million Americans, with 1 in 8 women developing a thyroid disorder during her lifetime. Although most patients with thyroid cancer have a good prognosis and effective treatments for benign thyroid disease are available, disparities exist in thyroid care and result in worse outcomes for racial and ethnic minorities. Inequities in the diagnosis and treatment of thyroid disease are due to the complex interplay of systems-, physician-, and patient-level factors. Thus, innovative strategies that take an ecological approach to addressing racial disparities are needed to achieve equitable care for all patients with thyroid disease.
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Affiliation(s)
- Debbie W Chen
- Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, 24 Frank Lloyd Wright Drive, PO Box 451, Ann Arbor, MI 48106, USA.
| | - Michael W Yeh
- Section of Endocrine Surgery, UCLA David Geffen School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
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Interaction of Gut Microbiota with Endocrine Homeostasis and Thyroid Cancer. Cancers (Basel) 2022; 14:cancers14112656. [PMID: 35681636 PMCID: PMC9179244 DOI: 10.3390/cancers14112656] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/22/2022] [Accepted: 05/24/2022] [Indexed: 01/27/2023] Open
Abstract
The gut microbiota plays a crucial role in healthy individuals as well as in patients with thyroid diseases, including thyroid cancer. Although the prognosis of differentiated thyroid cancer is predictable, that of some poorly differentiated, medullary, and anaplastic thyroid cancers remains unpromising. As the interaction between the gut microbiota and thyroid cancer has been gradually revealed in recent years, the thyroid gland, a crucial endocrine organ, is shown to have a complex connection with the body's metabolism and is involved in inflammation, autoimmunity, or cancer progression. Dysbiosis of the gut microbiota and its metabolites can influence changes in hormone levels and susceptibility to thyroid cancer through multiple pathways. In this review, we focus on the interactions of the gut microbiota with thyroid function diseases and thyroid cancer. In addition, we also discuss some potential new strategies for the prevention and treatment of thyroid disease and thyroid cancer. Our aim is to provide some possible clinical applications of gut microbiota markers for early diagnosis, treatment, and postoperative management of thyroid cancer. These findings were used to establish a better multi-disciplinary treatment and prevention management strategy and to individualize the treatment of patients in relation to their gut microbiota composition and pathological characteristics.
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The effects of Epigallocatechin-3-gallate and Dabrafenib combination on apoptosis and the genes involved in epigenetic events in anaplastic thyroid cancer cells. Med Oncol 2022; 39:98. [DOI: 10.1007/s12032-022-01688-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/17/2022] [Indexed: 11/27/2022]
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Boscoli SDS, Pereira IRPD, Segalla MRRC, Castro EMD. Carcinoma Anaplásico de Tireoide em uma Paciente Jovem: Relato de Caso. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n2.1860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Introdução: O carcinoma anaplásico da tireoide e um tumor raro e agressivo, que afeta principalmente mulheres com idade acima de 60 anos, sendo menos comum em pessoas mais jovens. Acredita-se que esse tumor surja em razão da perda de diferenciação em carcinomas bem diferenciados de tireoide. Uma baixa ingestão de iodo também foi sugerida. Apesar das tentativas de intervenção multimodal, o prognostico e ruim. Relato do caso: Paciente do sexo feminino, 41 anos, submetida a tireoidectomia total, por causa do rápido crescimento de massa tireoidiana, associada a suspeita radiológica de malignidade. A avaliação macroscópica mostrou que o tumor apresentava formato lobulado, áreas necróticas e hemorrágicas e margens mal definidas. Os achados microscópicos confirmaram um carcinoma anaplásico de tireoide, caracterizado pela proliferação de células multinucleadas fusiformes e osteoclásticas, associadas a um carcinoma papilar de tireoide bem diferenciado. Conclusão: Apesar de sua raridade, o carcinoma anaplásico deve ser considerado uma possibilidade na avaliação de uma neoplasia tireoidiana, e o diagnostico diferencial deve ser levado em conta com cautela, pois pode ser confundido com outros tumores, como linfomas e sarcomas. Além disso, e importante ressaltar a necessidade de considera-la mesmo quando o paciente nao pertence ao grupo epidemiológico usual.
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59
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McCrary HC, Aoki J, Huang Y, Chadwick B, Kerrigan K, Witt B, Hunt JP, Abraham D. Mutation based approaches to the treatment of anaplastic thyroid cancer. Clin Endocrinol (Oxf) 2022; 96:734-742. [PMID: 35067961 DOI: 10.1111/cen.14679] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/29/2021] [Accepted: 01/03/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The treatment of anaplastic thyroid cancer (ATC) has continued to rapidly evolve over time. Increased utilization of novel, personalized therapies based upon the tumour's somatic mutation status has recently been integrated. The aim of this case series is to describe a series of patients that underwent rapid genomic testing upon their diagnosis of ATC, allowing for the early integration of novel therapies. DESIGN A fast track pathway for genomic tumour analysis of patients with ATC was implemented at a single academic cancer hospital in January of 2020. PATIENTS All patients were evaluated by head and neck surgery, endocrinology, and medical oncology upon diagnosis of ATC. MEASUREMENTS Genetic work-up was completed, which prompted a recommendation for dual BRAF/MEK inhibition with dabrafenib and trametinib for tumours with BRAF V600E mutation. For patients whose tumours were BRAF V600E wild-type, pembrolizumab with lenvatinib was offered. RESULTS A total of four patients were included in this series. Two patients (50%) had tumours that were BRAF V600E positive. Among patients that were BRAF V600E positive, both patients initiated urgent dabrafenib and trametinib dual tyrosine kinase inhibitor (TKI) therapy; with one patient demonstrating near-complete clinical response allowing for posttreatment surgery, while the other demonstrated decreased tumour burden. Among patients who were BRAF V600E wild-type, lenvatinib and pembrolizumab were recommended off-label; one patient demonstrated decreased tumour burden, but developed severe pure red cell aplasia, while the other patient is demonstrating an early clinical response. CONCLUSIONS The integration of early genomic analysis and personalized neoadjuvant TKI therapy into the treatment of ATC can greatly benefit patient care outcomes and optimize tumour control.
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Affiliation(s)
- Hilary C McCrary
- Head and Neck Surgery, Division of Otolaryngology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Joni Aoki
- University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Yiqing Huang
- University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Barbara Chadwick
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Katie Kerrigan
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Benjamin Witt
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jason P Hunt
- Head and Neck Surgery, Division of Otolaryngology, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Dev Abraham
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Kanai T, Ito T, Morikawa H, Amitani M, Shimizu T, Ohno K, Ono M, Oba T, Maeno K, Ito KI. Surgical resection of the primary tumor prevents an undesirable locoregional condition and improves the quality of life in patients with anaplastic thyroid cancer. Surg Today 2022; 52:1620-1626. [DOI: 10.1007/s00595-022-02494-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/27/2022] [Indexed: 12/28/2022]
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Vithana SMP, Udayakumara EAD, Gunasena MDP, Mushraf MLM. Curative surgery for anaplastic thyroid carcinoma: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221091399. [PMID: 35449526 PMCID: PMC9016572 DOI: 10.1177/2050313x221091399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 03/15/2022] [Indexed: 11/17/2022] Open
Abstract
Anaplastic thyroid carcinoma accounts for 3%–4% of thyroid malignancies worldwide and is aggressive in nature with a median survival of 6 months at diagnosis. A 67-year-old lady with a hard goitre presented with compressive symptoms and mild hypothyroidism. Ultrasound scan revealed a Thyroid Imaging Reporting and Data System 5 lesion with suspicious left-sided cervical lymphadenopathy. Anaplastic carcinoma was diagnosed by fine needle aspiration cytology. Left-sided thyroid tumour with possible carotid sheath infiltration and left-sided cervical lymphadenopathy was seen on contrast-enhanced computed tomography of the neck. She underwent total thyroidectomy with therapeutic bilateral selective central and lateral cervical lymphadenectomy. Involvement of the aero-digestive tract and carotid sheath was not observed intra-operatively. Histology reported anaplastic carcinoma with deposits of papillary carcinoma in affected lymph nodes. Oncological management was commenced thereafter. Anaplastic thyroid carcinoma usually presents as advanced disease. However, current guidelines suggest a multimodal approach comprising of curative surgery whenever feasible with adjuvant radiotherapy and chemotherapy. For patients with stage IVa/IVb loco-regional disease as in our patient, total thyroidectomy with therapeutic lymphadenectomy to achieve R0/R1 resection plus adjuvant therapy is the current accepted practice. For locally advanced disease, surgery maybe opted after down-staging. The aim is to resect tumour wholly and not merely de-bulking. The presence of papillary carcinoma in lymph nodes points towards anaplasia occurring in a background of differentiated thyroid carcinoma in our patient similar to what literature suggests. This has implications in post-operative thyroxine suppression and radioiodine ablative therapies.
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Affiliation(s)
- SMP Vithana
- Department of Surgery, National Hospital Kandy, Kandy, Sri Lanka
| | - EAD Udayakumara
- Department of Surgery, National Hospital Kandy, Kandy, Sri Lanka
| | - MDP Gunasena
- Department of Surgery, National Hospital Kandy, Kandy, Sri Lanka
| | - MLM Mushraf
- Department of Surgery, National Hospital Kandy, Kandy, Sri Lanka
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Liu Q, Sun W, Zhang H. Roles and new Insights of Macrophages in the Tumor Microenvironment of Thyroid Cancer. Front Pharmacol 2022; 13:875384. [PMID: 35479325 PMCID: PMC9035491 DOI: 10.3389/fphar.2022.875384] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/21/2022] [Indexed: 12/17/2022] Open
Abstract
Although most thyroid cancers have a good and predictable prognosis, the anaplastic, medullary, and refractory thyroid cancers still prone to recurrence and metastasis, resulting in poor prognosis. Although a number of newly developed targeted therapies have begun to be indicated for the above types of thyroid cancer in recent years, their ability to improve overall survival remain hindered by low efficacy. As the largest component of immune cells in tumor microenvironment, tumor-associated macrophages play a key role in the invasion and metastasis of thyroid cancer. There is much evidence that the immune system, tumor microenvironment and cancer stem cell interactions may revolutionize traditional therapeutic directions. Tumor-associated macrophages have been extensively studied in a variety of tumors, however, research on the relationship between thyroid cancer and macrophages is still insufficient. In this review, we summarize the functions of tumor-associated macrophages in different types of thyroid cancer, their cytokines or chemokines effect on thyroid cancer and the mechanisms that promote tumor proliferation and migration. In addition, we discuss the mechanisms by which tumor-associated macrophages maintain the stemness of thyroid cancer and potential strategies for targeting tumor-associated macrophages to treat thyroid cancer.
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Tang J, Luo Y, Xiao L. USP26 promotes anaplastic thyroid cancer progression by stabilizing TAZ. Cell Death Dis 2022; 13:326. [PMID: 35397626 PMCID: PMC8994751 DOI: 10.1038/s41419-022-04781-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 09/07/2021] [Accepted: 09/22/2021] [Indexed: 12/21/2022]
Abstract
Anaplastic thyroid cancer (ATC) is one of the most lethal and aggressive human malignancies, with no effective treatment currently available. The Hippo tumor suppressor pathway is highly conserved in mammals and plays an important role in carcinogenesis. TAZ is one of major key effectors of the Hippo pathway. However, the mechanism supporting abnormal TAZ expression in ATC remains to be characterized. In the present study, we identified USP26, a DUB enzyme in the ubiquitin-specific proteases family, as a bona fide deubiquitylase of TAZ in ATC. USP26 was shown to interact with, deubiquitylate, and stabilize TAZ in a deubiquitylation activity-dependent manner. USP26 depletion significantly decreased ATC cell proliferation, migration, and invasion. The effects induced by USP26 depletion could be rescued by further TAZ overexpression. Depletion of USP26 decreased the TAZ protein level and the expression of TAZ/TEAD target genes in ATC, including CTGF, ANKRD1, and CYR61. In general, our findings establish a previously undocumented catalytic role for USP26 as a deubiquitinating enzyme of TAZ and provides a possible target for the therapy of ATC.
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Affiliation(s)
- Jianing Tang
- Department of Liver Surgery, Xiangya Hospital, Clinical Research Center for Breast Cancer Control and Prevention in Hunan Province, Central South University, Changsha, China.
| | - Yongwen Luo
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Liang Xiao
- Department of Liver Surgery, Xiangya Hospital, Clinical Research Center for Breast Cancer Control and Prevention in Hunan Province, Central South University, Changsha, China.
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ERKAN S, YABANOĞLU H, GÜNDOĞDU R, KUŞ M. Anaplastik Tiroid Karsinomlu Hastalarda Cerrahi Tedavi Yönetimimiz. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2022. [DOI: 10.17944/mkutfd.886278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Utilizing Three-Dimensional Culture Methods to Improve High-Throughput Drug Screening in Anaplastic Thyroid Carcinoma. Cancers (Basel) 2022; 14:cancers14081855. [PMID: 35454763 PMCID: PMC9031362 DOI: 10.3390/cancers14081855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/21/2022] [Accepted: 04/02/2022] [Indexed: 11/16/2022] Open
Abstract
Anaplastic thyroid carcinoma (ATC) is the most aggressive endocrine neoplasm, with a median survival of just four to six months post-diagnosis. Even with surgical and chemotherapeutic interventions, the five-year survival rate is less than 5%. Although combination dabrafenib/trametinib therapy was recently approved for treatment of the ~25% of ATCs harboring BRAFV600E mutations, there are no approved, effective treatments for BRAF-wildtype disease. Herein, we perform a screen of 1525 drugs and evaluate therapeutic candidates using monolayer cell lines and four corresponding spheroid models of anaplastic thyroid carcinoma. We utilize three-dimensional culture methods, as they have been shown to more accurately recapitulate tumor responses in vivo. These three-dimensional cultures include four distinct ATC spheroid lines representing unique morphology and mutational drivers to provide drug prioritization that will be more readily translatable to the clinic. Using this screen, we identify three exceptionally potent compounds (bortezomib, cabazitaxel, and YM155) that have established safety profiles and could potentially be moved into clinical trial for the treatment of anaplastic thyroid carcinoma, a disease with few treatment options.
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66
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Xu T, Jin T, Lu X, Pan Z, Tan Z, Zheng C, Liu Y, Hu X, Ba L, Ren H, Chen J, Zhu C, Ge M, Huang P. A signature of circadian rhythm genes in driving anaplastic thyroid carcinoma malignant progression. Cell Signal 2022; 95:110332. [DOI: 10.1016/j.cellsig.2022.110332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 01/02/2023]
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Lee WK, Zhu X, Park S, Zhu YJ, Zhao L, Meltzer P, Cheng SY. Regulation of cancer stem cell activity by thyroid hormone receptor β. Oncogene 2022; 41:2315-2325. [DOI: 10.1038/s41388-022-02242-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/10/2022] [Indexed: 12/20/2022]
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Systemic Therapy in Thyroid Cancer. Indian J Surg Oncol 2022; 13:68-80. [PMID: 35462658 PMCID: PMC8986938 DOI: 10.1007/s13193-021-01398-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022] Open
Abstract
Thyroid cancer is the most common endocrine malignancy. While surgery remains the mainstay of the treatment of all different histologies, for differentiated thyroid cancers, radioactive iodine also plays an important role in management. Once tumor becomes radio-iodine refractory, it needs systemic therapy. Earlier, these tumors had very dismal prognosis. However, with the advancement of technology and research, it has become clear now that thyroid cancer cells are driven by various mutations. Targeting these oncogenic drivers by various molecules have proven to be effective therapeutic strategy in thyroid cancer. Besides, as in other solid tumors, immunotherapy is also being evaluated in thyroid cancer. While these new therapeutic approaches have revolutionized the treatment on advanced/metastatic thyroid cancer, there are definite challenges which limit their use in common clinical practice. These challenges include higher treatment cost and lack of testing to identify the driver mutations. Moreover, there is still need for further research in thyroid cancers to identify oncogenic targets and agent to act upon them.
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Schuster-Bruce J, Sargent P, Madden B, Ofo E, Allin D. A systematic-review of endotracheal stenting in patients with locally advanced thyroid cancer. Clin Otolaryngol 2022; 47:414-423. [PMID: 35218682 DOI: 10.1111/coa.13923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 02/13/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Locally aggressive thyroid cancer can result in airway obstruction secondary to tracheal compression or vocal cord palsy. A tracheal stent provides an alternative to surgical resection, tracheostomy or conservative management in patients with compressive symptoms. This systematic review synthesises the current evidence associated with tracheal stenting in locally advanced thyroid cancer. DESIGN, SETTING AND PARTICIPANTS We conducted a systematic review of tracheal stenting in locally advanced thyroid cancers. We searched MEDLINE, Embase and Web of Science for studies until September 22nd 2020. Inclusion criteria were studies involving patients who had received tracheal stents to treat laryngo-tracheal stenosis secondary to locally advanced thyroid cancer. Single case reports or single cases were not included. MAIN OUTCOME MEASURES We assessed studies for data on the performance of tracheal stenting; defined as symptomatic relief, spirometry data, complication rates and mortality. We also extracted data pertaining to the use of different types of stent. RESULTS We identified 8 full-text articles from 325 titles found in our search. These were all single-centre retrospective studies that lacked homogeneity of thyroid cancer histotypes. The number of patients in each study ranged from 4 to 35 patients. Stenting improved performance status (2 of 2 studies), symptoms (5 of 5 studies) and spirometry (2 of 3 studies). The most common complications were tracheal granulation, tumor overgrowth, stent migration and sputum retention. CONCLUSION There is a lack of evidence in the literature of tracheal stents in locally advanced Thyroid cancer. However, the evidence available suggests tracheal stenting may be a useful treatment adjunct in advanced thyroid cancer causing symptomatic airway obstruction.
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Affiliation(s)
- James Schuster-Bruce
- Dept. of Ear, Nose and Throat, Head and Neck Surgery, St Georges University Hospitals NHS Trust, London, SW17 0QT
| | - Pippa Sargent
- Dept. of Medicine, St Georges University Hospitals NHS Trust, London, SW17 0QT
| | - Brendan Madden
- Dept. of Medicine, St Georges University Hospitals NHS Trust, London, SW17 0QT
| | - Enyinnaya Ofo
- Dept. of Ear, Nose and Throat, Head and Neck Surgery, St Georges University Hospitals NHS Trust, London, SW17 0QT
| | - David Allin
- Dept. of Ear, Nose and Throat, Head and Neck Surgery, Imperial College NHS Healthcare Trust, London, W6 8RF
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Pinto N, Ruicci KM, Khan MI, Shaikh MH, Zeng YFP, Yoo J, Fung K, MacNeil SD, Mendez A, Mymryk JS, Barrett JW, Boutros PC, Nichols AC. Introduction and expression of PIK3CAE545K in a papillary thyroid cancer BRAFV600E cell line leads to a dedifferentiated aggressive phenotype. JOURNAL OF OTOLARYNGOLOGY - HEAD & NECK SURGERY 2022; 51:7. [PMID: 35193694 PMCID: PMC8862267 DOI: 10.1186/s40463-022-00558-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/02/2022] [Indexed: 01/03/2023]
Abstract
Anaplastic thyroid cancer (ATC) is a rare, aggressive form of undifferentiated thyroid cancer, which exhibits rapid progression and is almost universally fatal. At least a subset of ATC is thought to arise from pre-existing well-differentiated thyroid cancer, most frequently papillary thyroid cancer (PTC). While PIK3CA mutations are rare in PTC, they are common in ATC and tend to co-occur with BRAF mutations. This provided the rationale for our study to identify the potential role of PIK3CA mutations in the progression from well-differentiated to undifferentiated thyroid cancer. We introduced PIK3CAE545K into the LAM1 PTC cell line, which carries a BRAFV600E mutation. In culture, the engineered cell line (LAM1:PIK3CAE545K) proliferated faster and demonstrated increased clonogenic potential relative to the parental line carrying an empty vector (LAM1EV). Both the LAM1EV and LAM1:PIK3CAE545K edited lines were implanted into hind flanks of athymic nude mice for in vivo determination of disease progression. While tumour weights and volumes were not significantly higher in LAM1:PIK3CAE545K mice, there was a decrease in expression of thyroid differentiation markers TTF-1, thyroglobulin, PAX8 and B-catenin, suggesting that introduction of PIK3CAE545K led to dedifferentiation in vivo. Collectively, this study provides evidence of a role for PIK3CAE545K in driving disease progression from a well-differentiated to an undifferentiated thyroid cancer; however, over-expression was not a determinant of an accelerated growth phenotype in ATC.
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Liu W, Wang S, Ye Z, Xu P, Xia X, Guo M. Prediction of lung metastases in thyroid cancer using machine learning based on SEER database. Cancer Med 2022; 11:2503-2515. [PMID: 35191613 PMCID: PMC9189456 DOI: 10.1002/cam4.4617] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 12/25/2021] [Accepted: 01/03/2022] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Lung metastasis (LM) is one of the most frequent distant metastases of thyroid cancer (TC). This study aimed to develop a machine learning algorithm model to predict lung metastasis of thyroid cancer for providing relative information in clinical decision-making. METHODS Data comprising of demographic and clinicopathological characteristics of patients with thyroid cancer were extracted from the National Institutes of Health (NIH)'s Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015, which is employed to develop six machine learning algorithm models support vector machine (SVM), logistic regression (LR), eXtreme gradient boosting (XGBoost), decision tree (DT), random forest (RF), and k-nearest neighbor (KNN). Compared and evaluated models by the following indicators: accuracy, precision, recall rate, F1-score, the area under the ROC curve (AUC) value and Brier score, and interpreted the association between clinicopathological characteristics and target variables based on the best model. RESULTS Nine thousand nine hundred and fifty patients were selected, which including 212 patients (2.1%) with lung metastasis, and 9738 patients without lung metastasis (97.9%). Multivariate logistic regression showed that age, T stage, N stage, and histological type were independent factors in TC with LM. Evaluation indicators of the best model- RF were as following: accuracy (0.99), recall rate (0.88), precision (0.61), F1-score (0.72), AUC value (0.99), and the Brier score (0.016). CONCLUSION RF learning model performed better and can be applied to forecast lung metastasis of thyroid cancer, and offer valuable and significant reference for clinicians' decision-making in advance.
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Affiliation(s)
- Wenfei Liu
- Department of Thyroid, Parathyroid, Breast and Hernia Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Shoufei Wang
- Department of Thyroid, Parathyroid, Breast and Hernia Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ziheng Ye
- Department of Thyroid, Parathyroid, Breast and Hernia Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Peipei Xu
- Department of Thyroid, Parathyroid, Breast and Hernia Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xiaotian Xia
- Department of Thyroid, Parathyroid, Breast and Hernia Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Minggao Guo
- Department of Thyroid, Parathyroid, Breast and Hernia Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Jannin A, Escande A, Al Ghuzlan A, Blanchard P, Hartl D, Chevalier B, Deschamps F, Lamartina L, Lacroix L, Dupuy C, Baudin E, Do Cao C, Hadoux J. Anaplastic Thyroid Carcinoma: An Update. Cancers (Basel) 2022; 14:cancers14041061. [PMID: 35205809 PMCID: PMC8869821 DOI: 10.3390/cancers14041061] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/06/2022] [Accepted: 02/14/2022] [Indexed: 01/13/2023] Open
Abstract
Anaplastic thyroid carcinoma (ATC) is a rare and undifferentiated form of thyroid cancer. Its prognosis is poor: the median overall survival (OS) of patients varies from 4 to 10 months after diagnosis. However, a doubling of the OS time may be possible owing to a more systematic use of molecular tests for targeted therapies and integration of fast-track dedicated care pathways for these patients in tertiary centers. The diagnostic confirmation, if needed, requires an urgent biopsy reread by an expert pathologist with additional immunohistochemical and molecular analyses. Therapeutic management, defined in multidisciplinary meetings, respecting the patient's choice, must start within days following diagnosis. For localized disease diagnosed after primary surgical treatment, adjuvant chemo-radiotherapy is recommended. In the event of locally advanced or metastatic disease, the prognosis is very poor. Treatment should then involve chemotherapy or targeted therapy and decompressive cervical radiotherapy. Here we will review current knowledge on ATC and provide perspectives to improve the management of this deadly disease.
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Affiliation(s)
- Arnaud Jannin
- Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille University Hospital, 59000 Lille, France; (A.J.); (B.C.); (C.D.C.)
- H. Warembourg School of Medicine, University of Lille, 59000 Lille, France;
| | - Alexandre Escande
- H. Warembourg School of Medicine, University of Lille, 59000 Lille, France;
- Academic Radiation Oncology Department, Oscar Lambret Center, 59000 Lille, France
| | - Abir Al Ghuzlan
- Cancer Medical Pathology and Biology Department, Institute Gustave Roussy, 94805 Villejuif, France;
| | - Pierre Blanchard
- Department of Radiation Oncology, Institute Gustave Roussy, Université Paris Saclay, 94805 Villejuif, France;
| | - Dana Hartl
- Département d’Anesthésie, Chirurgie et Interventionnel (DACI), Institute Gustave Roussy, Université Paris Saclay, 94805 Villejuif, France;
| | - Benjamin Chevalier
- Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille University Hospital, 59000 Lille, France; (A.J.); (B.C.); (C.D.C.)
- H. Warembourg School of Medicine, University of Lille, 59000 Lille, France;
| | - Frédéric Deschamps
- Department of Head and Neck Oncology, Institute Gustave Roussy, Université Paris Saclay, 94805 Paris, France;
| | - Livia Lamartina
- Cancer Medicine Department, Institute Gustave Roussy, Université Paris Saclay, 94805 Villejuif, France; (L.L.); (E.B.)
| | - Ludovic Lacroix
- Department of Medical Oncology, Institute Gustave Roussy, Université Paris Saclay, 94805 Villejuif, France;
| | | | - Eric Baudin
- Cancer Medicine Department, Institute Gustave Roussy, Université Paris Saclay, 94805 Villejuif, France; (L.L.); (E.B.)
| | - Christine Do Cao
- Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille University Hospital, 59000 Lille, France; (A.J.); (B.C.); (C.D.C.)
| | - Julien Hadoux
- Cancer Medicine Department, Institute Gustave Roussy, Université Paris Saclay, 94805 Villejuif, France; (L.L.); (E.B.)
- Correspondence: ; Tel.: +33-142116361
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Anaplastic thyroid carcinoma with unusual long-term survival: a case report. J Med Case Rep 2022; 16:39. [PMID: 35101107 PMCID: PMC8805419 DOI: 10.1186/s13256-021-03249-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/28/2021] [Indexed: 11/16/2022] Open
Abstract
Background Anaplastic thyroid carcinoma is a rare, rapidly progressive, and highly aggressive tumor. It has a global annual incidence of 1–2 per million people. It mostly affects older adults and women. The median survival duration after diagnosis does not exceed 6–8 months. Case presentation A 60-year-old female patient of mixed race (Honduran) presented to the local medical service with dysphonia that had started approximately 2 months earlier, accompanied by orthopnea that had started 1 month earlier. On physical examination, a soft mass was palpated within the anterior neck region; it was approximately 4 cm in diameter, painless, and mobile on swallowing, and had irregular margins. Ultrasound and computed tomography of the neck were performed. Subsequently, fine needle aspiration biopsy was performed. The histological diagnosis was anaplastic thyroid carcinoma (stage IVB). She underwent total thyroidectomy and chemotherapy. She is currently in her fifth year of remission after diagnosis and remains under oncologic surveillance. Discussion Anaplastic thyroid carcinoma demonstrates a lethal behavior. Approximately 18% survive for more than a year after diagnosis, and 0–10% survive for 5 years. Different pretherapeutic prognostic factors may affect survival, including age < 70 years, the absence of distant metastases, and complete local resection. Conclusion Conventional treatment improves the quality of life of the patient, but the results are not encouraging for the medium and long term. Only a few patients manage to exceed the average life expectancy of 3–6 months, despite undergoing the currently available therapeutic regimen.
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Management of lateral neck nodes in common and aggressive variants of thyroid cancer. Curr Opin Otolaryngol Head Neck Surg 2022; 30:130-136. [DOI: 10.1097/moo.0000000000000790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shih SR, Chen KH, Lin KY, Yang PC, Chen KY, Wang CW, Chen CN, Lin CF, Lin CC. Immunotherapy in anaplastic thyroid cancer: Case series. J Formos Med Assoc 2022; 121:1167-1173. [PMID: 35031200 DOI: 10.1016/j.jfma.2022.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/25/2021] [Accepted: 01/03/2022] [Indexed: 12/19/2022] Open
Abstract
Unresectable anaplastic thyroid cancer (ATC) has a poor prognosis. Chemotherapy and radiotherapy have limited effects on it. Here, we present four cases who underwent immunotherapy for ATC. The patients were aged between 58 and 70 years. Two male patients with pulmonary metastases received pembrolizumab and lenvatinib. However, they died of septic shock and respiratory failure in 2.7 and 1 months, respectively, after the initiation of combination therapy. Another male patient with stage IVB disease was treated with spartalizumab. The tumor remained stable after surgical debulking but slightly progressed after 23 months. He survived for 45.5 months after spartalizumab initiation. A female patient with BRAF-mutant ATC and lung metastases was treated with a combination of pembrolizumab and lenvatinib, which was complicated with grade 4 transaminitis. The patient subsequently received dabrafenib (a BRAF inhibitor) and trametinib (a MEK inhibitor) treatment, which was continued for 10.2 months with a best response of partial remission. She died 18 months after the initial diagnosis (11.4 months after treatment with dabrafenib and trametinib). In conclusion, the treatment responses of immunotherapy, either alone or in combination with other therapies, were highly variable in patients with ATC and should be carefully monitored along with the side effects.
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Affiliation(s)
- Shyang-Rong Shih
- National Taiwan University College of Medicine, Taipei, Taiwan; Division of Endocrinology & Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Center of Anti-Aging and Health Consultation, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Hua Chen
- Division of Endocrinology and Metabolism, E-Da Hospital, Kaohsiung, Taiwan
| | - Kuan-Yu Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Douliou City, Taiwan
| | - Pan-Chyr Yang
- National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Kuen-Yuan Chen
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Wei Wang
- Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Nan Chen
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Feng Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Chi Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
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Jin S, Liu X, Peng D, Li D, Ye YN. Differences Between Cancer-Specific Survival of Patients With Anaplastic and Primary Squamous Cell Thyroid Carcinoma and Factors Influencing Prognosis: A SEER Database Analysis. Front Endocrinol (Lausanne) 2022; 13:830760. [PMID: 35360080 PMCID: PMC8960140 DOI: 10.3389/fendo.2022.830760] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/11/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Anaplastic thyroid carcinoma (ATC) and primary squamous cell carcinoma of the thyroid (PSCCTh) have similar histological findings and are currently treated using the same approaches; however, the characteristics and prognosis of these cancers are poorly researched. The objective of this study was to determine the differences in characteristics between ATC and PSCCTh and establish prognostic models. PATIENTS AND METHODS All variables of patients with ATC and PSCCTh, diagnosed from 2004-2015, were retrieved from the Surveillance, Epidemiology, and End Results Program (SEER) database. Percentage differences for categorical data were compared using the Chi-square test. Kaplan-Meier curves, log-rank test, and Cox-regression for survival analysis, and C-index value was used to evaluate the performance of the prognostic models. RESULTS After application of the inclusion and exclusion criteria, a total of 1164 ATC and 124 PSCCTh patients, diagnosed from 2004 to 2015, were included in the study. There were no differences in sex, ethnicity, age, marital status, or percentage of proximal metastases between the two cancers; however, radiotherapy, chemotherapy, incidence of surgical treatment, and presence of multiple primary tumors were higher in patients with ATC than those with PSCCTh. Further cancer-specific survival (CSS) of patients with PSCCTh was better than that of patients with ATC. Prognostic factors were not identical for the two cancers. Multivariate Cox model analysis indicated that age, sex, radiotherapy, chemotherapy, surgery, multiple primary tumors, marital status, and distant metastasis status are independent prognostic factors for CSS in patients with ATC, while for patients with PSCCTh, the corresponding factors are age, radiotherapy, multiple primary tumors, and surgery. The C-index values of the two models were both > 0.8, indicating that the models exhibited good discriminative ability. CONCLUSION Prognostic factors influencing CSS were not identical in patients with ATC and PSCCTh. These findings indicate that different clinical treatment and management plans are required for patients with these two types of thyroid cancer.
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Affiliation(s)
- Shuai Jin
- Bioinformatics and Biomedical Big Data Mining Laboratory, Department of Medical Informatics, School of Big Health, Guizhou Medical University, Guiyang, China
| | - Xiangmei Liu
- School of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Dandan Peng
- School of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Dahuan Li
- School of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Yuan-Nong Ye
- Bioinformatics and Biomedical Big Data Mining Laboratory, Department of Medical Informatics, School of Big Health, Guizhou Medical University, Guiyang, China
- Cells and Antibody Engineering Research Center of Guizhou Province, Key Laboratory of Biology and Medical Engineering, School of Biology and Engineering, Guizhou Medical University, Guiyang, China
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
- *Correspondence: Yuan-Nong Ye,
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Huang D, Zhang J, Zheng X, Gao M. Efficacy and Safety of Lenvatinib in Anaplastic Thyroid Carcinoma: A Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:920857. [PMID: 35846304 PMCID: PMC9279913 DOI: 10.3389/fendo.2022.920857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/31/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Lenvatinib has shown promising efficacy in targeted therapies that have been tested to treat anaplastic thyroid carcinoma (ATC) in both preclinical and clinical studies. The aim of this study was to evaluate the efficacy and safety of lenvatinib in the treatment of patients with ATC. METHODS PubMed, the Cochrane Library, Embase, and ClinicalTrials.gov were searched for potential eligible studies from inception to February 1, 2022. The outcomes included partial response (PR), stable disease (SD), disease control rate (DCR), median progression-free survival (mPFS), and median overall survival (mOS). Effect sizes for all pooled results were presented with 95% CIs with upper and lower limit. RESULTS Ten studies met the inclusion criteria. The aggregated results showed that the pooled PR, SD, and DCR were 15.0%, 42.0%, and 63.0%, respectively. The pooled mPFS and mOS were 3.16 (2.18-5.60) months and 3.16 (2.17-5.64) months, respectively. Furthermore, PFS rate at 3 months (PFSR-3m), PFSR-6m, PFSR-9m, PFSR-12m, and PFSR-15m were 52.0%, 22.5%, 13.9%, 8.4%, and 2.5%, respectively. Meanwhile, the 3-month OS rate (OSR-3m), OSR-6m, OSR-9m, OSR-12m, and OSR-15m were 64.0%, 39.3%, 29.7%, 18.9%, and 14.2%, respectively. The most common adverse events (AEs) of lenvatinib were hypertension (56.6%), proteinuria (32.6%), and fatigue (32%). CONCLUSIONS This meta-analysis showed that lenvatinib has meaningful antitumor activity, but limited clinical efficacy in ATC. SYSTEMATIC REVIEW REGISTRATION PROSPERO [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022308624].
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Affiliation(s)
- Dongmei Huang
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Jinming Zhang
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Xiangqian Zheng
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- *Correspondence: Ming Gao, ; Xiangqian Zheng,
| | - Ming Gao
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Department of Thyroid and Breast Surgery, Tianjin Union Medical Center, Tianjin, China
- Tianjin Key Laboratory of General Surgery Inconstruction, Tianjin Union Medical Center, Tianjin, China
- *Correspondence: Ming Gao, ; Xiangqian Zheng,
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Lin S, Wei YR, Yao HX. Global Hotspots and Prospects of I-131 Therapy in Thyroid Carcinoma via Bibliometric Analysis. Int J Gen Med 2021; 14:9707-9718. [PMID: 34934347 PMCID: PMC8684403 DOI: 10.2147/ijgm.s339946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
Background Hundreds of studies have reported the application of iodine-131 (I-131) in thyroid carcinoma (THCA) in past years. However, the status of research in the field and other related topics have not been investigated. This study aimed to identify the cooperation of authors, countries, and institutions, as well as explore the hot topics and prospects regarding I-131 therapy in THCA based on previous studies. Methods Publications from 2010 to 2020 were retrieved from Web of Science Core Collection according to research strategy. Bibliometric analyses were performed using VOSviewer 1.6.15 and CiteSpace 5.7.3 to evaluate and visualize the cooperation network, hot topic, and research frontier. Results The number of publications showed a trend of fluctuation between 2010 and 2020. We identified 1387 publications related to I-131 therapy in THCA, which were published by 1628 institutions from 82 countries. The largest proportion of publications were emanated from the USA, and the majority of papers were published by Thyroid. Shanghai Jiao Tong University of China contributed the most papers. Although many authors participated in the research of this field, high-yield authors were few. Co-occurrence analysis classified keywords into five clusters, including assessment, efficacy measurement, monitoring, hormone regulation, and guidelines of I-131 therapy. The terms “bone marrow dosimetry and time” were among the latest hotspots. The research frontier topic in I-131 therapy focused on the “P53 and anti-Müllerian hormone”. Conclusion The attention to I-131 therapy in THCA should be increased considerably. It was necessary to construct active co-operations between authors, countries, and institutions to promote the development of this field. Recent researches referred to the timing and dose assessment of I-131 therapy in THCA. Future studies likely focused on targeted therapy and adverse effects evaluation were worthy of research as well.
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Affiliation(s)
- Shang Lin
- Department of Nuclear Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325002, People's Republic of China
| | - Ya-Ru Wei
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325002, People's Republic of China
| | - Hong-Xiang Yao
- Department of Interventional Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325002, People's Republic of China
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Wang H, Yu Y, Wang K, Sun H. Bibliometric Insights in Advances of Anaplastic Thyroid Cancer: Research Landscapes, Turning Points, and Global Trends. Front Oncol 2021; 11:769807. [PMID: 34900720 PMCID: PMC8652235 DOI: 10.3389/fonc.2021.769807] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/01/2021] [Indexed: 01/06/2023] Open
Abstract
Background Thyroid cancers are the most common endocrine malignancies with a dramatic increase in incidences. Anaplastic thyroid cancer is a rare but deadly form among thyroid cancers. To better understand of this field, we assessed the global scientific outputs and tried to depict its overview via bibliometric methods. Methods Approximately 1,492 science publications published between 1997 and 2020 were included by systematic retrieval in the WoS database. The general information of them was characterized, and the developmental skeleton and research frontiers were explored. Results The article number in this field has been increasing in the past 24 years. North America, East Asia, and Western Europe have reached remarkable achievements. Mutations of BARF and TERT and their downstream pathways have attracted researchers’ attention, where genetic diagnosis provides new clinical insight and several targeted therapeutic approaches have been on the clinical trial. Conclusions Numerous efforts have been made to figure out gene expression reprogramming of anaplastic thyroid cancer and key mechanism in driving its dedifferentiation, invasion and migration process. Targeted therapy, immunotherapy, and systematic combination therapy are the recent current research hotspots. These results provide insightful clues for the funding direction and the potential breakthrough direction of the anaplastic thyroid cancer study.
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Affiliation(s)
- Hanyu Wang
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuxin Yu
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kang Wang
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Forensic Medicine, Nanjing Medical University, Nanjing, China
| | - Hui Sun
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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81
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Misiak D, Bauer M, Lange J, Haase J, Braun J, Lorenz K, Wickenhauser C, Hüttelmaier S. MiRNA Deregulation Distinguishes Anaplastic Thyroid Carcinoma (ATC) and Supports Upregulation of Oncogene Expression. Cancers (Basel) 2021; 13:cancers13235913. [PMID: 34885022 PMCID: PMC8657272 DOI: 10.3390/cancers13235913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 12/13/2022] Open
Abstract
Anaplastic thyroid carcinoma (ATC) is the most fatal and rapidly evolving endocrine malignancy invading the head and neck region and accounts for up to 50% of thyroid cancer-associated deaths. Deregulation of the microRNA (miRNA) expression promotes thyroid carcinoma progression by modulating the reorganization of the ATC transcriptome. Here, we applied comparative miRNA-mRNA sequencing on a cohort of 28 thyroid carcinomas to unravel the association of deregulated miRNA and mRNA expression. This identified 85 miRNAs significantly deregulated in ATC. By establishing a new analysis pipeline, we unraveled 85 prime miRNA-mRNA interactions supporting the downregulation of candidate tumor suppressors and the upregulation of bona fide oncogenes such as survivin (BIRC5) in ATC. This miRNA-dependent reprogramming of the ATC transcriptome provided an mRNA signature comprising 65 genes sharply distinguishing ATC from other thyroid carcinomas. The validation of the deregulated protein expression in an independent thyroid carcinoma cohort demonstrates that miRNA-dependent oncogenes comprised in this signature, the transferrin receptor TFRC (CD71) and the E3-ubiquitin ligase DTL, are sharply upregulated in ATC. This upregulation is sufficient to distinguish ATC even from poorly differentiated thyroid carcinomas (PDTC). In sum, these findings provide new diagnostic tools and a robust resource to explore the key miRNA-mRNA regulation underlying the progression of thyroid carcinoma.
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Affiliation(s)
- Danny Misiak
- Institute of Molecular Medicine, Martin Luther University Halle-Wittenberg, 06120 Halle, Germany; (D.M.); (J.L.); (J.H.); (J.B.)
| | - Marcus Bauer
- Institute of Pathology, Martin Luther University Halle-Wittenberg, 06112 Halle, Germany; (M.B.); (C.W.)
| | - Jana Lange
- Institute of Molecular Medicine, Martin Luther University Halle-Wittenberg, 06120 Halle, Germany; (D.M.); (J.L.); (J.H.); (J.B.)
| | - Jacob Haase
- Institute of Molecular Medicine, Martin Luther University Halle-Wittenberg, 06120 Halle, Germany; (D.M.); (J.L.); (J.H.); (J.B.)
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Juliane Braun
- Institute of Molecular Medicine, Martin Luther University Halle-Wittenberg, 06120 Halle, Germany; (D.M.); (J.L.); (J.H.); (J.B.)
- Merck KGaA, 64293 Darmstadt, Germany
| | - Kerstin Lorenz
- Department of Visceral, Vascular, and Endocrine Surgery, Martin Luther University Halle-Wittenberg, 06120 Halle, Germany;
| | - Claudia Wickenhauser
- Institute of Pathology, Martin Luther University Halle-Wittenberg, 06112 Halle, Germany; (M.B.); (C.W.)
| | - Stefan Hüttelmaier
- Institute of Molecular Medicine, Martin Luther University Halle-Wittenberg, 06120 Halle, Germany; (D.M.); (J.L.); (J.H.); (J.B.)
- Correspondence:
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82
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Wächter S, Di Fazio P, Maurer E, Manoharan J, Keber C, Pfestroff A, Librizzi D, Bartsch DK, Luster M, Eilsberger F. Prostate-Specific Membrane Antigen in Anaplastic and Poorly Differentiated Thyroid Cancer-A New Diagnostic and Therapeutic Target? Cancers (Basel) 2021; 13:cancers13225688. [PMID: 34830843 PMCID: PMC8616254 DOI: 10.3390/cancers13225688] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/01/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023] Open
Abstract
Several studies have demonstrated an expression of the prostate-specific membrane antigen (PSMA) in the cancer-related neovasculature of thyroid malignancies. Due to the poor prognosis and limited therapeutic options for patients with anaplastic (ATC) and poorly differentiated (PDTC) thyroid carcinoma, the aim of our study was to investigate the theranostic approach of PSMA expression in these patients. The PSMA uptake on Gallium-68 (68Ga)-PSMA-positron emission tomography/computed tomography (PET/CT) and glucose uptake on F-18-Fluordeoxyglucose (18F-FDG)-PET/CTs were analysed in two ATC and six PDTC patients. The PSMA expression in corresponding patients' tissue samples was detected by immunohistochemistry. In addition, various tissue sections from 22 ATC and six PDTC patients were examined concerning PSMA expression. 68Ga-PSMA-PET/CT showed heterogeneous PSMA expression among patients and lesions. Six of the eight analyzed patients (two ATC, four PDTC) showed increased glucose metabolism without increased PSMA uptake after PET/CT. In one patient (PDTC), 18F-FDG-PET/CT tracer uptake was positive and 68Ga-PSMA-PET/CT showed heterogeneous results. Another patient (PDTC) evidenced only PSMA-positive lesions and received two cycles of Lutetium-177 (177Lu)-PSMA therapy, which kept his disease stable for seven months. There was a correlation between immunohistochemical PSMA expression and uptake on 68Ga-PMSA-PET/CT in three of the examined patients. Twenty-seven of the analyzed 39 ATC and 13 of the analyzed 22 PDTC tissue sections showed a strong PSMA expression. Considering the rarity of PDTC and ATC, which is the reason for the small patient population we studied, the findings of this study confirm the high diagnostic sensitivity and superiority of 18F-FDG-PET/CT in comparison to 68Ga-PSMA-PET/CT in the diagnosis of ATC and PDTC. However, it can be suggested that 68Ga-PMSA-PET/CT can be considered as a beneficial adjunct to the well-established 18F-FDG-PET/CT for a few individual selected patients with ATC and PDTC to detect lesions not discovered by 18F-FDG-PET/CT and to determine patients' eligibility for a radioligand therapy. Radiolabelled PSMA-ligands may, in the future, represent a theranostic approach with only minor side effects for a few individual selected patients with ATC and PDTC who need alternative treatment options in case of progression when established therapies are no longer effective. However, due to the small sample size of our collective, larger studies are needed to allow for a final evaluation on the significance of PSMA-targeted diagnostic and therapy for ATC and PDTC.
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Affiliation(s)
- Sabine Wächter
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, 35043 Marburg, Germany; (P.D.F.); (E.M.); (J.M.); (D.K.B.)
- Correspondence: ; Tel.: +49-642-158-69-644; Fax: +49-642-158-63-851
| | - Pietro Di Fazio
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, 35043 Marburg, Germany; (P.D.F.); (E.M.); (J.M.); (D.K.B.)
| | - Elisabeth Maurer
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, 35043 Marburg, Germany; (P.D.F.); (E.M.); (J.M.); (D.K.B.)
| | - Jerena Manoharan
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, 35043 Marburg, Germany; (P.D.F.); (E.M.); (J.M.); (D.K.B.)
| | - Corinna Keber
- Department of Pathology, University Hospital Marburg, 35043 Marburg, Germany;
| | - Andreas Pfestroff
- Department of Nuclear Medicine, University Hospital Marburg, 35043 Marburg, Germany; (A.P.); (D.L.); (M.L.); (F.E.)
| | - Damiano Librizzi
- Department of Nuclear Medicine, University Hospital Marburg, 35043 Marburg, Germany; (A.P.); (D.L.); (M.L.); (F.E.)
| | - Detlef K. Bartsch
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, 35043 Marburg, Germany; (P.D.F.); (E.M.); (J.M.); (D.K.B.)
| | - Markus Luster
- Department of Nuclear Medicine, University Hospital Marburg, 35043 Marburg, Germany; (A.P.); (D.L.); (M.L.); (F.E.)
| | - Friederike Eilsberger
- Department of Nuclear Medicine, University Hospital Marburg, 35043 Marburg, Germany; (A.P.); (D.L.); (M.L.); (F.E.)
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Lee WK, Cheng SY. Targeting transcriptional regulators for treatment of anaplastic thyroid cancer. JOURNAL OF CANCER METASTASIS AND TREATMENT 2021; 7. [PMID: 34761120 PMCID: PMC8577520 DOI: 10.20517/2394-4722.2021.58] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dysregulation of genes perpetuates cancer progression. During carcinogenesis, cancer cells acquire dependency of aberrant transcriptional programs (known as “transcription addiction”) to meet the high demands for uncontrolled proliferation. The needs for particular transcription programs for cancer growth could be cancer-type-selective. The dependencies of certain transcription regulators could be exploited for therapeutic benefits. Anaplastic thyroid cancer (ATC) is an extremely aggressive human cancer for which new treatment modalities are urgently needed. Its resistance to conventional treatments and the lack of therapeutic options for improving survival might have been attributed to extensive genetic heterogeneity due to subsequent evolving genetic alterations and clonal selections during carcinogenesis. Despite this genetic complexity, mounting evidence has revealed a characteristic transcriptional addiction of ATC cells resulting in evolving diverse oncogenic signaling for cancer cell survival. The transcriptional addiction has presented a huge challenge for effective targeting as shown by the failure of previous targeted therapies. However, an emerging notion is that many different oncogenic signaling pathways activated by multiple upstream driver mutations might ultimately converge on the transcriptional responses, which would provide an opportunity to target transcriptional regulators for treatment of ATC. Here, we review the current understanding of how genetic alterations in cancer distorted the transcription program, leading to acquisition of transcriptional addiction. We also highlight recent findings from studies aiming to exploit the opportunity for targeting transcription regulators as potential therapeutics for ATC.
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Affiliation(s)
- Woo Kyung Lee
- Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sheue-Yann Cheng
- Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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84
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Zhang Y, Li K, Wang W, Han J. miR-381-3p attenuates doxorubicin resistance in human anaplastic thyroid carcinoma via targeting homeobox A9. Int J Exp Pathol 2021; 102:209-217. [PMID: 34719830 DOI: 10.1111/iep.12401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 12/12/2022] Open
Abstract
Abnormal microRNA (miR) expression has frequently been reported to be implicated in cancer-related drug resistance. Herein, we planned to investigate whether miR-381-3p contributes to doxorubicin (DOX) resistance in anaplastic thyroid carcinoma (ATC). DOX-resistant ATC tissues and cell lines were prepared to detect miR-381-3p and homeobox A9 (HOXA9) expression. CCK8, transwell and TUNEL assays were performed to evaluate cell proliferation, migration and invasion, and apoptosis in in vitro experiments. HOXA9 expression is intensively expressed in ATC tissues compared with benign thyroid tissues. Compared with parental ATC cell lines, HOXA9 protein expression is significantly up-regulated in DOX-resistant SW1736 and CAL62 cells. The knockdown of HOXA9 leads to growth inhibition and apoptosis of DOX-resistant SW1736 and CAL62 cells. Our results also indicate a significant decrease in miR-381-3p expression levels in DOX-resistant ATC tissues and cell lines. miR-381-3p may function as a tumour suppressor to impede proliferation, migration and invasion and induce apoptosis of DOX-resistant SW1736 and CAL62 cells by inhibiting HOXA9 protein expression. Our results present a novel signalling axis miR-381-3p/HOXA9 that mediates DOX resistance in ATC. miR-381-3p and HOXA9 may be promising molecular targets for preventing ATC progression and drug resistance.
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Affiliation(s)
- Yan Zhang
- Department of Internal Medicine, The People Hospital of Huaiyin of Jinan, Jinan, China
| | - Ke Li
- Department of Head and Neck Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Weili Wang
- Department of Head and Neck Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Jingjing Han
- Department of Head and Neck Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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85
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Maniakas A, Henderson YC, Hei H, Peng S, Chen Y, Jiang Y, Ji S, Cardenas M, Chiu Y, Bell D, Williams MD, Hofmann MC, Scherer SE, Wheeler DA, Busaidy NL, Dadu R, Wang JR, Cabanillas ME, Zafereo M, Johnson FM, Lai SY. Novel Anaplastic Thyroid Cancer PDXs and Cell Lines: Expanding Preclinical Models of Genetic Diversity. J Clin Endocrinol Metab 2021; 106:e4652-e4665. [PMID: 34147031 PMCID: PMC8530744 DOI: 10.1210/clinem/dgab453] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Anaplastic thyroid cancer (ATC) is a rare, aggressive, and deadly disease. Robust preclinical thyroid cancer models are needed to adequately develop and study novel therapeutic agents. Patient-derived xenograft (PDX) models may resemble patient tumors by recapitulating key genetic alterations and gene expression patterns, making them excellent preclinical models for drug response evaluation. OBJECTIVE We developed distinct ATC PDX models concurrently with cell lines and characterized them in vitro and in vivo. METHODS Fresh thyroid tumor from patients with a preoperative diagnosis of ATC was surgically collected and divided for concurrent cell line and PDX model development. Cell lines were created by generating single cells through enzymatic digestion. PDX models were developed following direct subcutaneous implantation of fresh tumor on the flank of immune compromised/athymic mice. RESULTS Six ATC PDX models and 4 cell lines were developed with distinct genetic profiles. Mutational characterization showed one BRAF/TP53/CDKN2A, one BRAF/CDKN2A, one BRAF/TP53, one TP53 only, one TERT-promoter/HRAS, and one TERT-promoter/KRAS/TP53/NF2/NFE2L2 mutated phenotype. Hematoxylin-eosin staining comparing the PDX models to the original patient surgical specimens show remarkable resemblance, while immunohistochemistry stains for important biomarkers were in full concordance (cytokeratin, TTF-1, PAX8, BRAF). Short tandem repeats DNA fingerprinting analysis of all PDX models and cell lines showed strong concordance with the original tumor. PDX successful establishment rate was 32%. CONCLUSION We have developed and characterized 6 novel ATC PDX models with 4 matching cell lines. Each PDX model harbors a distinct genetic profile, making them excellent tools for preclinical therapeutic trials.
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Affiliation(s)
- Anastasios Maniakas
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
- Division of Oto-rhino-laryngology-Head and Neck Surgery, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Quebec, H1T 2M4, Canada
| | - Ying C Henderson
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Hu Hei
- Department of Thyroid and Neck, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China
| | - Shaohua Peng
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Yunyun Chen
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Yujie Jiang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Shuangxi Ji
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Maria Cardenas
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Yulun Chiu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Diana Bell
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Michelle D Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Marie-Claude Hofmann
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Steve E Scherer
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, USA
| | - David A Wheeler
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Naifa L Busaidy
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Ramona Dadu
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Jennifer R Wang
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Maria E Cabanillas
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Mark Zafereo
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Faye M Johnson
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Stephen Y Lai
- Department of Molecular and Cellular Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
- Correspondence: Stephen Y. Lai, MD, PhD, Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1445, Houston, TX 77030, USA.
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Chen Y, Xu S, Zeng X, Liang Y, Xu J. Comparison of the effectiveness and safety between endoscopic-assisted lateral neck dissection and conventional open lateral neck dissection:A meta-analysis. Asian J Surg 2021; 45:1809-1816. [PMID: 34649793 DOI: 10.1016/j.asjsur.2021.09.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/23/2021] [Accepted: 09/30/2021] [Indexed: 11/02/2022] Open
Abstract
The objective of this study was to systematically evaluate the effectiveness and safety of endoscopic-assisted lateral neck dissection (EALND) compared with conventional open lateral neck dissection (COLND) for the treatment of thyroid cancer with positive lymph node metastases. Medical literature databases including PubMed, Embase, the Cochrane Library, CNKI, Wan Fang and VIP were systematically searched for articles that compared EALND and COLND for the treatment of thyroid carcinoma with lymph node metastasis, up to June 2019. The quality of included studies was evaluated using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using RevMan 5.3 software after two evaluators independently screened the literature, extracted information and evaluated the methodological quality of included studies according to inclusion and exclusion criteria, resulting in the selection of seven studies with a total of 372 patients from six non-RCTs and an RCT. The results of meta-analysis showed that EALND was associated with a longer operative time (MD = 24.86, 95∗CI:21.76 to 27.96, P<0.05), with a shorter postoperative stay (MD = -1.45, 95%CI:-2.70 to -0.21,P = 0.02), reduced length of scar (MD = -8.14,95%CI:-8.41 to -7.88, P<0.00001) and a lower incidence of neck discomfort (OR = 0.19, 95%CI:0.07 to 0.58, P = 0.003) compared with COLND. The incidences in both groups of transient hypocalcemia (OR = 0.66,95%CI:0.28 to 1.55,P = 0.343), transient hoarseness (OR = 0.58,95%CI:0.17 to 1.93,P = 0.38),chylous fistula (OR = 0.69,95%CI:0.26 to 1.83,P = 0.45), choking on water (OR = 0.24,95%CI:0.04 to 1.31,P = 0.10) and the number of lymph nodes retrieved from the lateral cervical region (MD = 0.14,95%CI:-0.36 to 0.65,P = 0.59) were not statistically significant. It was concluded that EALND was safe and feasible compared with COLND, despite the longer operation time. The incision was more aesthetically pleasing and the postoperative recovery was quicker, which makes EALND a clinical procedure worthy of use in such cases.
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Affiliation(s)
- Yongqiang Chen
- Department of Thyroid Breast Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, 362000, PR China
| | - Shuangta Xu
- Department of Thyroid Breast Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, 362000, PR China
| | - Xiaoshan Zeng
- Department of Thyroid Breast Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, 362000, PR China
| | - Yinghui Liang
- Department of Thyroid Breast Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, 362000, PR China
| | - Jianhua Xu
- Department of Thyroid Breast Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, 362000, PR China.
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The Role of IONM in Reducing the Occurrence of Shoulder Syndrome Following Lateral Neck Dissection for Thyroid Cancer. J Clin Med 2021; 10:jcm10184246. [PMID: 34575355 PMCID: PMC8469441 DOI: 10.3390/jcm10184246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/30/2021] [Accepted: 09/15/2021] [Indexed: 12/01/2022] Open
Abstract
Lateral neck dissection (LND) leads to a significant morbidity involving accessory nerve injury. Modified radical neck dissection (MRND) aims at preservation of the accessory nerve, but patients often present with negative functional outcomes after surgery. The role of neuromonitoring (IONM) in the prevention of shoulder syndrome has not yet been defined in comparison to nerve visualization only. We retrospectively analyzed 56 thyroid cancer patients who underwent MRND over a period of six years (2015–2020) in a high-volume institution. Demographic variables, type of surgical procedure, removed lymph nodes and the metastatic node ratio, pathology, adoption of IONM and shoulder functional outcome were investigated. The mean number of lymph nodes removed was 15.61, with a metastatic node ratio of 0.2745. IONM was used in 41.07% of patients, with a prevalence of 68% in the period 2017–2020. IONM adoption showed an effect on post-operative shoulder function. There were no effects in 89.29% of cases, and temporary and permanent effects in 8.93% and 1.79%, respectively. Confidence intervals and two-sample tests for equality of proportions were used when applicable. Expertise in high-volume centres and IONM during MRND seem to be correlated with a reduced prevalence of accessory nerve lesions and limited functional impairments. These results need to be confirmed by larger prospective randomized controlled trials.
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Huang S, Wu Y, Li C, Xu L, Huang J, Huang Y, Cheng W, Xue B, Zhang L, Liang S, Jin X, Zhu X, Xiong S, Su Y, Wang H. Tailoring morphologies of mesoporous polydopamine nanoparticles to deliver high-loading radioiodine for anaplastic thyroid carcinoma imaging and therapy. NANOSCALE 2021; 13:15021-15030. [PMID: 34533142 DOI: 10.1039/d1nr02892h] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Anaplastic thyroid carcinoma (ATC), as one of the most aggressive human malignancies, cannot be cured by 131iodine (131I) internal radiotherapy (RT) because the tumor cells cannot effectively take up 131I and are resistant to radiotherapy. In this study, a facile and simple method was proposed to synthesize mesoporous polydopamine nanoparticles (MPDA) and tailor their morphologies by component-adjusting Pluronic micelle-guided polymerization. Then, MPDA were used not only as nanocarriers to radiolabel 131I, but also as photothermal conversion agents for photothermal therapy (PTT) to promote RT. The iodine-labeling capacity and photothermal conversion efficiency of MPDA can be enhanced by optimizing their morphologies. It was found that MPDA NPs with a cerebroid pore channel structure (CPDA) showed the highest iodine-carrying capacity and a higher photothermal conversion efficiency as a result of their maximum specific surface area and unique morphology. In subsequent experiments in vitro and in vivo, our ATC animal models showed impressive therapeutic responses to CPDA-131I NPs because of the synergistic effect of PTT and RT. Additionally, CPDA-125I NPs can be utilized to obtain high-quality SPETC/CT images of tumors, which can guide clinical therapy for ATC. Considering their great biosafety, these radioiodine-labeled CPDA NPs may serve as a promising tool in combined therapy and diagnosis in ATC.
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Affiliation(s)
- Shuo Huang
- Department of Nuclear Medicine, Xin Hua Hospital Affiliated To Shanghai Jiao Tong University School, 1665 Kongjiang Road, Shanghai 200092, China.
| | - Yan Wu
- School of Chemistry and Chemical Engineering, State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.
| | - Chao Li
- Department of Nuclear Medicine, Xin Hua Hospital Affiliated To Shanghai Jiao Tong University School, 1665 Kongjiang Road, Shanghai 200092, China.
| | - Li Xu
- School of Chemistry and Chemical Engineering, State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.
| | - Jie Huang
- School of Chemistry and Chemical Engineering, State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.
| | - Yu Huang
- School of Chemistry and Chemical Engineering, State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.
| | - Weiwei Cheng
- Department of Nuclear Medicine, Xin Hua Hospital Affiliated To Shanghai Jiao Tong University School, 1665 Kongjiang Road, Shanghai 200092, China.
| | - Bai Xue
- School of Chemistry and Chemical Engineering, State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.
| | - Linlin Zhang
- Department of Nuclear Medicine, Xin Hua Hospital Affiliated To Shanghai Jiao Tong University School, 1665 Kongjiang Road, Shanghai 200092, China.
| | - Sheng Liang
- Department of Nuclear Medicine, Xin Hua Hospital Affiliated To Shanghai Jiao Tong University School, 1665 Kongjiang Road, Shanghai 200092, China.
| | - Xin Jin
- School of Chemistry and Chemical Engineering, State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.
| | - Xinyuan Zhu
- School of Chemistry and Chemical Engineering, State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.
| | - Shuqiang Xiong
- School of Chemistry and Chemical Engineering, State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.
| | - Yue Su
- School of Chemistry and Chemical Engineering, State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.
| | - Hui Wang
- Department of Nuclear Medicine, Xin Hua Hospital Affiliated To Shanghai Jiao Tong University School, 1665 Kongjiang Road, Shanghai 200092, China.
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89
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Yang SR, Tsai MH, Hung CJ, Peng SL, Chiu NT, Huang YH, Tsai HJ. Anaplastic Thyroid Cancer Successfully Treated With Radiation and Immunotherapy: A Case Report. AACE Clin Case Rep 2021; 7:299-302. [PMID: 34522768 PMCID: PMC8426608 DOI: 10.1016/j.aace.2021.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/03/2021] [Indexed: 01/15/2023] Open
Abstract
Objective Anaplastic thyroid cancer (ATC) is a rare thyroid cancer subtype with a devastating prognosis. Novel treatment strategies are under investigation to improve the survival of patients with ATC. Methods We present a case of recurrent ATC treated with a combination of radiation therapy (RT) and pembrolizumab, a programmed death-1 inhibitor, with a durable complete response. Results A 63-year-old woman underwent total thyroidectomy and left neck lymph node dissection and was diagnosed with papillary carcinoma in December, 2017. She received radioiodine in April, 2018. However, a left neck mass was noted in April, 2018 with biopsy demonstrating ATC with 95% positivity for programmed death-ligand 1 immunostaining. Positron emission tomography showed fluorodeoxyglucose uptake in the left thyroid bed and multiple lymph nodes in the left retropharyngeal, left neck, and right upper paratracheal areas. Hypofractionated RT for the recurrent areas was initiated in August,2018, and concomitant pembrolizumab was given 2 days after RT. A total of 10 cycles of pembrolizumab (2 mg/kg) were given every 3 weeks. The computed tomography scan after completion of RT and 3 cycles of pembrolizumab showed shrinkage of the neck lymph nodes. The serial follow-up computed tomography scans showed further shrinkage of the lymph nodes, and there was no recurrence of ATC as of October, 2020. Conclusion We describe an ATC case successfully treated with a combination of RT and pembrolizumab with a durable response of 26 months and acceptable toxicities. This result warrants further investigation of this combination regimen in the treatment of ATC.
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Affiliation(s)
- Shuen-Ru Yang
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mu-Hung Tsai
- Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Jye Hung
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shu-Ling Peng
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nan-Tsing Chiu
- Department of Nuclear Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Hui Huang
- Nursing Department of National Cheng Kung University Hospital, Tainan, Taiwan
| | - Hui-Jen Tsai
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan.,Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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90
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Ferrari SM, Elia G, Ragusa F, Paparo SR, Mazzi V, Miccoli M, Galdiero MR, Varricchi G, Foddis R, Guglielmi G, Spinelli C, La Motta C, Benvenga S, Antonelli A, Fallahi P. Lenvatinib: an investigational agent for the treatment of differentiated thyroid cancer. Expert Opin Investig Drugs 2021; 30:913-921. [PMID: 34428101 DOI: 10.1080/13543784.2021.1972971] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Differentiated thyroid cancer (DTC; >90% of all TCs) derives from follicular cells. Surgery is the main therapeutic strategy, and radioiodine (RAI) is administered after thyroidectomy. When DTC progresses, it does not respond to RAI and thyroid-stimulating hormone (TSH)-suppressive thyroid hormone treatment, and other therapies (i.e. surgery, external beam radiation therapy and chemotherapy) do not lead to a better survival. Thanks to the understanding of the molecular pathways involved in TC progression, important advances have been done. Lenvatinib is a multitargeted tyrosine kinase inhibitor of VEGFR1-3, FGFR1-4, PDGFRα, RET, and KIT signaling networks implicated in tumor angiogenesis, approved in locally recurrent or metastatic, progressive, RAI-refractory DTC. Unmet needs regarding the patient clinical therapy responsiveness in aggressive RAI-refractory DTC still remain. AREAS COVERED We provide an overview from the literature of in vitro, in vivo and real-life studies regarding lenvatinib as an investigational agent for the treatment of aggressive TC. EXPERT OPINION According to the SELECT trial, the treatment should be initiated with a dosage of 24 mg/day, subsequently decreasing it in relation to the side effects. The decision making process in patients with aggressive RAI-refractory DTC should be personalized and the potential toxicity should be properly managed.
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Affiliation(s)
| | - Giusy Elia
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Francesca Ragusa
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Valeria Mazzi
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Maria Rosaria Galdiero
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples, Italy; WAO Center of Excellence, Naples, Italy; Institute of Experimental Endocrinology and Oncology "G. Salvatore" (IEOS), National Research Council (CNR),Naples, Italy
| | - Gilda Varricchi
- Department of Translational Medical Sciences and Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples, Italy; WAO Center of Excellence, Naples, Italy; Institute of Experimental Endocrinology and Oncology "G. Salvatore" (IEOS), National Research Council (CNR),Naples, Italy
| | - Rudy Foddis
- Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giovanni Guglielmi
- U.O. Medicina Preventiva Del Lavoro, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Claudio Spinelli
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | | | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.,Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Messina, Italy.,Interdepartmental Program of Molecular and Clinical Endocrinology and Women's Endocrine Health, Azienda Ospedaliera Universitaria Policlinico 'G. Martino', Messina, Italy
| | - Alessandro Antonelli
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Poupak Fallahi
- Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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91
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Kim HJ, Chang HS, Ryu YH. Prognostic Role of Pre-Treatment [ 18F]FDG PET/CT in Patients with Anaplastic Thyroid Cancer. Cancers (Basel) 2021; 13:cancers13164228. [PMID: 34439382 PMCID: PMC8391441 DOI: 10.3390/cancers13164228] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/13/2021] [Accepted: 08/20/2021] [Indexed: 01/18/2023] Open
Abstract
Simple Summary This study evaluates the prognostic capability of the 18fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET)/computed tomography (CT) in patients with anaplastic thyroid cancer (ATC) which can be used as a potential biomarker reflecting glycolysis. ATC is a rare, but highly lethal disease with a one-year overall survival of 20%, and its prognostic factors have rarely been investigated. In this study, survival data correlated with PET/CT derived parameters provide evidence that FDG uptake assessed by PET/CT is a prognostic marker, which may have a clinical impact on the management of patients with ATC. Abstract Anaplastic thyroid carcinoma (ATC) is a rare but highly lethal disease. Therefore, its diagnosis at an early stage and a rapid and accurate establishment of a proper treatment strategy is warranted. Tumor glycolysis assessed by 18fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET)/computed tomography (CT) is predictive of many cancers despite its limited proven applicability to ATC. We investigated the prognostic capability of [18F]FDG PET/CT in patients with ATC. Forty patients with ATC were subjected to [18F]FDG PET/CT for pre-treatment evaluation. The tumor size and stage, overall survival (OS), and PET parameters, including the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were analyzed. The 1-year OS rate was 17.5% with a mean life expectancy of 7.1 months. Distant metastasis was detected solely using PET/CT in 37.5% of cases. High SUVmax, MTV, and TLG were significantly associated with poor prognosis (p < 0.001, p = 0.002, and p < 0.001, respectively). A significant difference (p < 0.001) was observed in OS between patients with a high and low tumor SUVmax. Glucose metabolism assessed by [18F]FDG PET/CT was significantly associated with the OS of patients with ATC. PET-derived parameters such as SUVmax, MTV, and TLG are useful prognostic biomarkers for ATC.
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Affiliation(s)
- Hyun Jeong Kim
- Department of Nuclear Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea;
| | - Hang-Seok Chang
- Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
- Correspondence: (H.-S.C.); (Y.H.R.); Tel.: +82-2-2019-3510 (H.-S.C.)
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
- Correspondence: (H.-S.C.); (Y.H.R.); Tel.: +82-2-2019-3510 (H.-S.C.)
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92
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Abstract
Primary thyroid cancers demonstrate distinct biological behaviors depending on their histologic characteristics. The ability to accumulate radioiodine by differentiated thyroid cancer cells is lost in primary aggressive, poorly differentiated and dedifferentiated tumor cells. PET imaging comes into play in these challenging situations where it can provide additive information to radioiodine scintigraphy and conventional imaging. This review focuses on the current guidelines and future prospects of PET imaging in thyroid cancers.
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93
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Kawamura Y, Saijo K, Imai H, Ishioka C. Inhibition of IRAK1/4 enhances the antitumor effect of lenvatinib in anaplastic thyroid cancer cells. Cancer Sci 2021; 112:4711-4721. [PMID: 34328666 PMCID: PMC8586669 DOI: 10.1111/cas.15095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 07/19/2021] [Accepted: 07/27/2021] [Indexed: 11/26/2022] Open
Abstract
Anaplastic thyroid cancer (ATC) is an extremely aggressive tumor associated with poor prognosis due to a lack of efficient therapies. In Japan, lenvatinib is the only drug approved for patients with ATC; however, its efficacy is limited. Therefore, novel therapeutic strategies are urgently required for patients with ATC. The present study aimed to identify compounds that enhance the antiproliferative effects of lenvatinib in ATC cells using a compound library. IRAK1/4 Inhibitor I was identified as a candidate compound. Combined treatment with lenvatinib and IRAK1/4 Inhibitor I showed synergistic antiproliferative effects via induction of cell cycle arrest at G2/M phase in the ATC cell lines 8305C, HTC/C3, ACT-1, and 8505C. Furthermore, IRAK1/4 Inhibitor I enhanced the inhibition of ERK phosphorylation by lenvatinib in 8305C, HTC/C3, and 8505C cells. In an HTC/C3 xenograft mouse model, tumor volume was lower in the combined IRAK1/4 Inhibitor I and lenvatinib group compared with that in the vehicle control, IRAK1/4 Inhibitor I, and lenvatinib groups. IRAK1/4 Inhibitor I was identified as a promising compound that enhances the antiproliferative and antitumor effects of lenvatinib in ATC.
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Affiliation(s)
- Yoshifumi Kawamura
- Department of Clinical Oncology, Institute for Development, Aging, and Cancer, Tohoku University, Sendai, Japan
| | - Ken Saijo
- Department of Clinical Oncology, Institute for Development, Aging, and Cancer, Tohoku University, Sendai, Japan
| | - Hiroo Imai
- Department of Clinical Oncology, Institute for Development, Aging, and Cancer, Tohoku University, Sendai, Japan
| | - Chikashi Ishioka
- Department of Clinical Oncology, Institute for Development, Aging, and Cancer, Tohoku University, Sendai, Japan.,Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Japan
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94
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Moore A, Bar Y, Maurice-Dror C, Finkel I, Goldvaser H, Dudnik E, Goldstein DA, Gordon N, Billan S, Gutfeld O, Wolf I, Popovtzer A. Next-generation sequencing in thyroid cancers: do targetable alterations lead to a therapeutic advantage?: A multicenter experience. Medicine (Baltimore) 2021; 100:e26388. [PMID: 34160418 PMCID: PMC8238320 DOI: 10.1097/md.0000000000026388] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 04/29/2021] [Accepted: 05/25/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT Radioiodine-refractory thyroid cancers (IRTCs) are uncommon and have a poor prognosis. Treatment options for radioiodine-refractory and anaplastic tumors (ATCs) are limited. Although the genomic landscape of thyroid cancer has been studied, there is little evidence on whether next-generation sequencing (NGS) findings translate to tumor control.We analyzed all patients with IRTC and ATC who underwent commercially available NGS in 3 cancer centers.Twenty-two patients were identified, 16 patients with IRTCs and 6 patients with ATCs. Eighteen (82%) had targetable findings in NGS, nine patients were treated accordingly. Median progression-free survival for targeted treatment was 50 months [95% confidence interval (CI95%) 9.8-66.6] and2 months (CI95% 0.2-16.5) for IRTC and ATC, respectively. Of 4 patients who achieved durable responses of 7 to 50 months, 2 are ongoing. The estimated median OS of IRTC receiving targeted treatment was not reached (CI95% 89.7-111.4 months) and was 77.8 months (CI95% 52.5-114.6) for patients treated conventionally (P = .3).NGS may detect clinically significant genetic alterations and benefit patients with advanced thyroid cancers.
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Affiliation(s)
- Assaf Moore
- Institute of Oncology, Davidoff Center, Rabin Medical Center – Beilinson Hospital, Petach Tikva
- Sackler Faculty of Medicine, Tel Aviv University
| | - Yael Bar
- Sackler Faculty of Medicine, Tel Aviv University
- Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv
| | - Corinne Maurice-Dror
- Institute of Oncology, Rambam Health Care Campus
- Ruth & Bruce Rappaport, Faculty of Medicine, Technion Israel Institute of Technology, Haifa
| | - Inbar Finkel
- Institute of Oncology, Davidoff Center, Rabin Medical Center – Beilinson Hospital, Petach Tikva
| | - Hadar Goldvaser
- Oncology Institute, Shaare Zedek Medical Center
- The Hebrew University Faculty of Medicine, Jerusalem, Israel
| | - Elizabeth Dudnik
- Institute of Oncology, Davidoff Center, Rabin Medical Center – Beilinson Hospital, Petach Tikva
- Sackler Faculty of Medicine, Tel Aviv University
| | - Daniel A. Goldstein
- Institute of Oncology, Davidoff Center, Rabin Medical Center – Beilinson Hospital, Petach Tikva
- Sackler Faculty of Medicine, Tel Aviv University
| | - Noa Gordon
- Institute of Oncology, Davidoff Center, Rabin Medical Center – Beilinson Hospital, Petach Tikva
| | - Salem Billan
- Institute of Oncology, Rambam Health Care Campus
- Ruth & Bruce Rappaport, Faculty of Medicine, Technion Israel Institute of Technology, Haifa
| | - Orit Gutfeld
- Sackler Faculty of Medicine, Tel Aviv University
- Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv
| | - Ido Wolf
- Sackler Faculty of Medicine, Tel Aviv University
- Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv
| | - Aron Popovtzer
- Institute of Oncology, Davidoff Center, Rabin Medical Center – Beilinson Hospital, Petach Tikva
- Sackler Faculty of Medicine, Tel Aviv University
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95
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Liu C, Zhou X, Pan Y, Liu Y, Zhang Y. Pyruvate carboxylase promotes thyroid cancer aggressiveness through fatty acid synthesis. BMC Cancer 2021; 21:722. [PMID: 34158007 PMCID: PMC8220755 DOI: 10.1186/s12885-021-08499-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 06/11/2021] [Indexed: 12/24/2022] Open
Abstract
Background Pyruvate carboxylase (PC) is an important anaplerotic enzyme in the tricarboxylic acid cycle (TCA) in cancer cells. Although PC overexpression has been observed in thyroid cancer (TC), the mechanisms involved in the carcinogenic effects of PC are still unclear. Methods Bioinformatics analysis and clinical specimens were used to analyze the relationship of PC expression with clinicopathological variables in TC. Fatty acid synthesis was monitored by LC/MS, Nile red staining, and triglyceride analysis. Mitochondrial oxygen consumption was evaluated by the Seahorse XF Mito Cell Stress Test. The correlation of PC with FASN and SREBP1c was assessed by qRT-PCR and IHC in 38 human TC tissues. Western blotting was used to evaluate the protein expression of PC, FASN, and SREBP1c and members of the AKT/mTOR and EMT pathways in TC cell lines. Wound-healing, CCK-8, and Transwell assays and a nude mouse xenograft model were used to verify the regulatory effects of PC and SREBP1c on thyroid tumor cell proliferation, migration and invasion. Results We demonstrated that PC increased fatty acid synthesis, which then promoted TC progression and metastasis. Analysis of GEO data showed that the overexpression of PC in papillary thyroid cancer (PTC) was associated with PTC invasion and the fatty acid synthesis pathway. Analysis of clinical tissue specimens from PTC patients revealed that PC was more highly expressed in specimens from PTC patients with lymph node metastasis than in those from patients without metastasis. Multiple genes in the fatty acid synthesis signaling pathway, including FASN and SREBP1c, were downregulated in PC-knockdown TC cells compared to control cells. Lipid levels were also decreased in the PC-knockdown TC cells. Moreover, the ability of cells to grow, invade, and metastasize was also suppressed upon PC knockdown, suggesting that PC-mediated lipogenesis activation increases the aggressiveness of TC cells. In addition, PC was found to activate the AKT/mTOR pathway, thus improving FASN-mediated de novo lipogenesis in TC cells by upregulating SREBP1c expression. Studies in a nude mouse xenograft model showed that PC knockdown decreased tumor weight, but this effect was attenuated by forced expression of SREBP1c. Conclusions Our results demonstrate that PC is strongly involved in the tumor aggressiveness of TC via its stimulation of fatty acid synthesis. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08499-9.
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Affiliation(s)
- Chang Liu
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Xiang Zhou
- Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Pan
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Yang Liu
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Yifan Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China.
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96
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Augustin T, Oliinyk D, Rauch J, Koehler VF, Spitzweg C, Belka C, KÄsmann L. Radiation to the Primary Tumor in Metastatic Anaplastic Thyroid Cancer. In Vivo 2021; 35:461-465. [PMID: 33402497 DOI: 10.21873/invivo.12279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 11/29/2020] [Accepted: 12/01/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIM Metastatic anaplastic thyroid cancer is associated with a dismal prognosis. We evaluated outcome and prognostic factors in patients receiving radiation to the primary tumor in metastatic anaplastic thyroid cancer (ATC). PATIENTS AND METHODS All consecutive patients with metastatic ATC (n=20) undergoing irradiation between 2009 and 2019 for anaplastic thyroid cancer were investigated. RESULTS Median survival time and median progression-free survival were 2 (range=1-22) and 2 (1-20) months. In univariate analyses, surgery, concurrent or sequential chemotherapy and higher radiation dose escalation (>39 Gy) were correlated with longer overall survival (p=0.005, p=0.018 and p=0.038), respectively. Karnofsky performance status >70% showed a trend of longer survival time (p=0.062). Limited metastatic disease, surgery and concurrent/sequential chemotherapy are correlated with longer progression-free survival times (p=0.043, p=0.024 and p=0.039), respectively. CONCLUSION Radiation to the primary tumor in metastatic anaplastic thyroid cancer is safe and offers durable local control. Treatment intensification including concurrent or sequential chemotherapy and radiation dose escalation were associated with longer survival rates and should be considered in selected patients with metastatic disease.
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Affiliation(s)
- Teresa Augustin
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Dmytro Oliinyk
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Josefine Rauch
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | | | - Christine Spitzweg
- Department of Internal Medicine IV, University Hospital, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Lukas KÄsmann
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany; .,German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
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97
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Rossi D, Belotti A, di Tonno C, Midolo V, Maffini FA, Nicosia L, De Fiori E, Mauri G. Changes in thyroid fine needle aspiration practice during the COVID-19 pandemic. Cytopathology 2021; 32:732-737. [PMID: 34137099 PMCID: PMC8597111 DOI: 10.1111/cyt.13020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/03/2021] [Accepted: 06/06/2021] [Indexed: 12/30/2022]
Abstract
Purpose To investigate the diagnostic accuracy of a different sample preparation protocol for fine needle aspiration cytology (FNAC) of thyroid nodules established during the COVID‐19 pandemic. Methods From April 2020, conventional smears during FNAC were ceased according to World Health Organization recommendations due to the increased infection risk for operators, and a new protocol using only liquid‐based cytology (LBC) was adopted. FNACs performed between April and July 2020 (COVID‐19 group) were retrospectively compared with those from December 2019 through March 2020 (Pre‐COVID‐19 group). The distribution of diagnoses based on SIAPEC‐IAP categories and the concordance between cytological and histological results were compared using the chi‐squared test. Results Categories based on FNAC for 90 and 82 thyroid nodules in the Pre‐COVID‐19 and COVID‐19 groups showed no significant difference in distribution (P = .081), with the following respective cases (and percentages): TIR1, 7 (8%) and 8 (10%); TIR1C, 0 (0%) and 6 (7%); TIR2, 59 (66%) and 55 (67%); TIR3A, 8 (9%) and 5 (6%); TIR3B, 1 (1%) and 2 (3%); TIR4, 5 (6%) and 1 (1%); and TIR5, 10 (12%) and 5 (7%). Among patients with potentially malignant lesions, surgery was performed for 12/16 (75%) nodules in the Pre‐COVID‐19 and 7/8 (88%) nodules in the COVID‐19 groups, with no significant differences between cytological and histological diagnoses (P = .931). Conclusion The new LBC‐only protocol provided similar diagnostic accuracy in comparison with conventional smears, and can be effectively applied during a viral pandemic improving operator safety.
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Affiliation(s)
- Duccio Rossi
- Postgraduate School of Radiodiagnostics, Università Degli Studi di Milano, Milan, Italy
| | - Alessia Belotti
- Postgraduate School of Pathology, Università Degli Studi di Milano, Milan, Italy
| | - Clementina di Tonno
- Division of Cytopathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Valeria Midolo
- Division of Cytopathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Luca Nicosia
- Department of Breast Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elvio De Fiori
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giovanni Mauri
- Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy.,Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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98
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Survival Benefit of Intervention Treatment in Advanced Anaplastic Thyroid Cancer. Int J Surg Oncol 2021; 2021:5545127. [PMID: 34123423 PMCID: PMC8192187 DOI: 10.1155/2021/5545127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 05/19/2021] [Accepted: 05/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background The management of anaplastic thyroid cancer (ATC) is controversial; thus, proper treatment and prognostic factors should be investigated. Objectives To compare the survival outcomes of the intervention and palliative treatment in ATC patients. Methods A hospital-based retrospective study was conducted at a single tertiary university hospital. The medical record charts were retrieved from November 20, 1987, to December 31, 2016. The final follow-up ended by December 31, 2017. The patients' demographic data, laboratory data, clinical presentation, and treatment modality results were analyzed. Results One hundred twenty-one records were analyzed with a one-year overall survival rate of 3.5% (median survival time: 77 days); however, 16 cases had insufficient data to classify staging and treatment modalities. Therefore, 105 ATC patients (37 with stage IVa, 39 with stage IVb, and 29 with stage IVc disease) were included with a one-year overall survival rate of 4.0% (median survival time of 82 days). Intervention treatment allowed longer median survival times (p < 0.05) and a better survival rate (p < 0.05). Among the interventional treatment groups, postoperative chemoradiation yielded the longest median survival time (187 days) and the highest survival rate (20%) (p < 0.05). The intervention modality allowed a better median survival time at all stages, particularly in stage IVa (p < 0.05). Unfavorable prognostic factors were adjusted for in a multiple Cox regression model showing that significant factors included age ≥65 years (hazard ratio HR: 2.57), palliative treatment (HR: 1.85), and leukocytosis ≥10,000 cells/mm3 (HR: 2.76). Conclusions Intervention treatment provided a better survival outcome in all stages, particularly in stage IVa, with a significantly better median survival time. Among interventional treatments, postoperative chemoradiation led to the longest survival rate, suggesting that this treatment should be considered in ATC patients with resectable tumors and no poor prognostic factors, such as older age and leukocytosis.
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Wang Y, Hu Z, Ma W, Niu Y, Su J, Zhang L, Zhao P. Signal transducer and activator of transcription 3 inhibition alleviates resistance to BRAF inhibition in anaplastic thyroid cancer. Invest New Drugs 2021; 39:764-774. [PMID: 33245464 DOI: 10.1007/s10637-020-01024-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/20/2020] [Indexed: 12/15/2022]
Abstract
Anaplastic thyroid cancer (ATC) is a rare type of thyroid cancer (TC) with no effective therapeutic strategy. Although surgery, chemotherapy and radiation are all available for ATC treatment, the median survival for ATC patients is less than 6 months. In this study, we aimed to study on resistant mechanisms to B-Raf proto-oncogene serine/threonine kinase (BRAF) inhibitor and identify effective combinational therapy for ATC patients. TC cells were treated with Vemurafenib and cell apoptosis and viability were analyzed by flow cytometry and MTT assay. Monolayer and sphere cells were isolated from ATC cells to detect the mRNA level of stem cell markers and differentiation markers by RT-PCR. Phosphor-STAT3 level in sphere and monolayer cells was tested by Western blotting. The xenotransplantation animal model has established to analyze the anti-tumor effect of Vemurafenib and Stattic combinational therapy. Undifferentiated TC cells were resistant to Vemurafenib treatment. Sphere cells isolated from ATC showed no significant change in cell viability and apoptosis upon Vemurafenib treatment, and expressed a high level of stem cell marker and phosphor-STAT3. STAT3 inhibition enhanced the tumorigenic capacity and increased Vemurafenib sensitivity in ATC cell lines. Stattic significantly enhanced anti-tumor effect of Vemurafenib in mouse model. Our findings demonstrate that the combinational therapy of Vemurafenib and Stattic is an effective therapeutic treatment for ATC patients.
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Affiliation(s)
- Ying Wang
- The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, 050000, Hebei, China
| | - Zhigang Hu
- The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, 050000, Hebei, China
| | - Weiyuan Ma
- The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, 050000, Hebei, China
| | - Yong Niu
- Quyang People's Hospital, Taihang Road, Quyang County, Baoding, 071000, Hebei, China
| | - Jingwei Su
- Quyang People's Hospital, Taihang Road, Quyang County, Baoding, 071000, Hebei, China
| | - Lingxiang Zhang
- Xingtai Ninth Hospital, No.163 Jiankang East Road, Julu County, Xingtai, 054000, Hebei, China
| | - Pengxin Zhao
- The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang, 050000, Hebei, China.
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Al-Qurayshi Z, Sullivan CB, Khadra H, Shama M, Lee GS, Kandil E. Presentation and outcomes of patients with undifferentiated thyroid carcinoma: a national perspective. Gland Surg 2021; 10:1971-1979. [PMID: 34268081 DOI: 10.21037/gs-20-927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/14/2021] [Indexed: 11/06/2022]
Abstract
Background Undifferentiated thyroid cancer (UTC) accounts for only 1-2% of all thyroid cancers. UTC is one of the most aggressive solid tumors with high metastatic rates and mortality. The objectives of this study are to examine the characteristics of patients with UTC and their overall survival. Methods Retrospective analysis utilizing the National Cancer Database, 2004-2014 is performed. The study population included adults (≥18 years) patients with UTC or differentiated thyroid carcinoma (DTC), which served as a reference group. Results A total of 1,870 UTC and 209,707 DTC patients were identified. The median follow-up time of UTC patients was 3.9 months (interquartile range: 1.6-9.0 months). When compared to DTC patients, patients with UTC were more likely to be ≥45-year-old [OR: 48.62, 95% CI: (35.75, 66.14), P<0.001], male [OR: 2.02, 95% CI: (1.84, 2.22), P<0.001], and/or black [OR: 1.27, 95% CI: (1.08, 1.49), P=0.004]. UTC patients were more likely to have Medicaid/Medicare or no insurance and treated in low-volume hospitals (P<0.001). Overall survival in patients with UTC was lower in patients older than 65 years [OR: 1.63, 95% CI: (1.12, 2.38), P=0.011], with multiple comorbidities [OR: 1.65, 95% CI: (1.02, 2.67), P=0.040] and/or presented with metastatic disease [OR: 1.93, 95% CI: (1.71, 2.17), P<0.001]. Compared to thyroidectomy alone, patients without metastasis who received adjuvant radiotherapy and/or chemotherapy had a better overall survival (P<0.001 each). In patients with metastatic disease, any intervention or combination of interventions other than thyroidectomy alone improved survival (P<0.05). Conclusions Older age, male, and/or black are associated with a higher prevalence of UTC compared to DTC. Although overall survival is poor in UTC, utilization of multi-modal treatment may improve survival.
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Affiliation(s)
- Zaid Al-Qurayshi
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Christopher Blake Sullivan
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Helmi Khadra
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Mohamed Shama
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Grace S Lee
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Emad Kandil
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
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