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Zhang Y, Zheng WH, Zhou SH, Gu JL, Yu Q, Zhu YZ, Yan YJ, Zhu Z, Shang JB. Molecular genetics, therapeutics and RET inhibitor resistance for medullary thyroid carcinoma and future perspectives. Cell Commun Signal 2024; 22:460. [PMID: 39342195 PMCID: PMC11439284 DOI: 10.1186/s12964-024-01837-x] [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: 06/23/2024] [Accepted: 09/18/2024] [Indexed: 10/01/2024] Open
Abstract
Medullary thyroid carcinoma (MTC) is a rare type of thyroid malignancy that accounts for approximately 1-2% of all thyroid cancers (TCs). MTC include hereditary and sporadic cases, the former derived from a germline mutation of rearrangement during transfection (RET) proto-oncogene, whereas somatic RET mutations are frequently present in the latter. Surgery is the standard treatment for early stage MTC, and the 10-year survival rate of early MTC is over 80%. While for metastatic MTC, chemotherapy showing low response rate, and there was a lack of effective systemic therapies in the past. Due to the high risk (ca. 15-20%) of distant metastasis and limited systemic therapies, the 10-year survival rate of patients with advanced MTC was only 10-40% from the time of first metastasis. Over the past decade, targeted therapy for RET has developed rapidly, bringing hopes to patients with advanced and progressive MTC. Two multi-kinase inhibitors (MKIs) including Cabozantinib and Vandetanib have been shown to increase progression-free survival (PFS) for patients with metastatic MTC and have been approved as choices of first-line treatment. However, these MKIs have not prolonged overall survival (OS) and their utility is limited due to high rates of off-target toxicities. Recently, new generation TKIs, including Selpercatinib and Pralsetinib, have demonstrated highly selective efficacy against RET and more favorable side effect profiles, and gained approval as second-line treatment options. Despite the ongoing development of RET inhibitors, the management of advanced and progressive MTC remains challenging, drug resistance remains the main reason for treatment failure, and the mechanisms are still unclear. Besides, new promising therapeutic approaches, such as novel drug combinations and next generation RET inhibitors are under development. Herein, we overview the pathogenesis, molecular genetics and current management approaches of MTC, and focus on the recent advances of RET inhibitors, summarize the current situation and unmet needs of these RET inhibitors in MTC, and provide an overview of novel strategies for optimizing therapeutic effects.
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Affiliation(s)
- Ying Zhang
- Department of Thyroid Surgery, Zhejiang Cancer Hospital, No. 1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang, China
- Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, Shanghai, China
| | - Wei-Hui Zheng
- Department of Thyroid Surgery, Zhejiang Cancer Hospital, No. 1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang, China
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Shi-Hong Zhou
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jia-Lei Gu
- Department of Thyroid Surgery, Zhejiang Cancer Hospital, No. 1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Malignant Tumor, Hangzhou, Zhejiang, China
| | - Qing Yu
- Department of Thyroid Surgery, Zhejiang Cancer Hospital, No. 1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang, China
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yi-Zhou Zhu
- Department of Thyroid Surgery, Zhejiang Cancer Hospital, No. 1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang, China
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yu-Jie Yan
- Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, Shanghai, China
| | - Zhi Zhu
- The MOE Key Laboratory of Spectrochemical Analysis & Instrumentation, The Key Laboratory of Chemical Biology of Fujian Province, State Key Laboratory of Physical Chemistry of Solid Surfaces, Department of Chemical Biology, College of Chemistry and Chemical Engineering, Xiamen University, Xiamen, 361005, China.
| | - Jin-Biao Shang
- Department of Thyroid Surgery, Zhejiang Cancer Hospital, No. 1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang, China.
- Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, Zhejiang, China.
- Zhejiang Provincial Clinical Research Center for Malignant Tumor, Hangzhou, Zhejiang, China.
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Shirali AS, Hu MI, Chiang YJ, Graham PH, Fisher SB, Sosa JA, Perrier N, Brown S, Holla VR, Dadu R, Busaidy N, Sherman SI, Cabanillas M, Waguespack SG, Zafereo ME, Grubbs EG. Next-Generation Sequencing in Sporadic Medullary Thyroid Cancer Patients: Mutation Profile and Disease Aggressiveness. J Endocr Soc 2024; 8:bvae048. [PMID: 38660141 PMCID: PMC11041404 DOI: 10.1210/jendso/bvae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Indexed: 04/26/2024] Open
Abstract
Context Next-generation sequencing (NGS) analysis of sporadic medullary thyroid carcinoma (sMTC) has led to increased detection of somatic mutations, including RET M918T, which has been considered a negative prognostic indicator. Objective This study aimed to determine the association between clinicopathologic behavior and somatic mutation identified on clinically motivated NGS. Methods In this retrospective cohort study, patients with sMTC who underwent NGS to identify somatic mutations for treatment planning were identified. Clinicopathologic factors, time to distant metastatic disease (DMD), disease-specific survival (DSS), and overall survival (OS) were compared between somatic mutations. Results Somatic mutations were identified in 191 sMTC tumors, including RET M918T (53.4%), other RET codons (10.5%), RAS (18.3%), somatic RET indels (8.9%), and RET/RAS wild-type (WT) status (8.9%). The median age at diagnosis was 50 years (range, 11-83); 46.1% were female. When comparing patients with RET M918T, RET-Other, and RET WT (which included RAS and RET/RAS WT), there were no differences in sex, TNM category, systemic therapy use, time to DMD, DSS, or OS. On multivariate analysis, older age at diagnosis (HR 1.05, P < .001; HR 1.06, P< .001) and M1 stage at diagnosis (HR 3.17, P = .001; HR 2.98, P = .001) were associated with decreased DSS and OS, respectively, but mutation cohort was not. When comparing RET M918T to RET indels there was no significant difference in time to DMD, DSS, or OS between the groups. Conclusion Somatic RET mutations do not portend compromised DSS or OS in a cohort of sMTC patients who underwent clinically motivated NGS.
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Affiliation(s)
- Aditya S Shirali
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mimi I Hu
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Yi-Ju Chiang
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Paul H Graham
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sarah B Fisher
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Julie Ann Sosa
- Department of Surgery, University of California-San Francisco (UCSF), San Francisco, CA 94143, USA
| | - Nancy Perrier
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Spandana Brown
- Department of Endocrinology, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Vijaykumar R Holla
- Institute of Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ramona Dadu
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Naifa Busaidy
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Steven I Sherman
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Maria Cabanillas
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Steven G Waguespack
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mark E Zafereo
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Elizabeth G Grubbs
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Tarasova VD, Tsai J, Masannat J, Hernandez Prera JC, Hallanger Johnson J, Veloski C, Agosto Salgado S, McIver B, Drusbosky LM, Chung CH. Characterization of the Thyroid Cancer Genomic Landscape by Plasma-Based Circulating Tumor DNA Next-Generation Sequencing. Thyroid 2024; 34:197-205. [PMID: 37962267 DOI: 10.1089/thy.2023.0204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background: The limited availability of targeted therapies in thyroid cancer (TC) has challenged conventional treatment algorithms and has established urgency for the identification of targetable genomic abnormalities. In addition to widely adopted tissue-based next-generation sequencing (NGS), plasma-based circulating tumor DNA (ctDNA) NGS is rapidly emerging as a genomic biomarker detection method and is steadily gaining utility across solid tumors. To date, plasma-based genomic alterations in TC have not been determined. Herein, we profile potential actionable mutations detected through ctDNA in patients with TC subtypes. Methods: A retrospective data analysis of the Guardant Health, Inc. database was performed using the commercially available Guardant360® plasma-NGS test on TC samples from adult patients collected between 2016 and 2021. The landscape of genomic alterations and blood tumor mutation burden (bTMB) were analyzed in patients with different types of TC: anaplastic TC (ATC), papillary TC (PTC), follicular TC (FTC), oncolytic carcinoma of the thyroid (OCA), poorly differentiated TC (PDTC), medullary TC (MTC), and TC not otherwise specified (TC NOS). Results: Of the 1094 patients included most of the patients n = 876 had TC NOS, and 20% had a specific diagnosis (92 ATC, 62 PTC, 14 FTC, 16 OCA, 2 PDTC, and 32 MTC patients). The median age was 65 (range 10-98) and 47.3% were male. 78.3% of patients had one or more genomic alteration detected by ctDNA NGS. TP53 (46.9%) was the most common mutation detected among all TC. BRAFV600E was detected in 27.2% of ATC, 35.7% of PTC, and in none of FTC. RAS was detected in 18.5% of ATC, 11.9% of PTC, and 62.5% of FTC. RET, ALK, and NTRK fusions were seen in 1.1%, 0.5%, and 0.2% of all TC, respectively. RET mutations were detected in 66.7% of MTC. bTMB analysis was performed on 159 patients. The mean bTMB was higher in ATC compared with other types of TC (p = 0.0011, 0.0557, and <0.0001, respectively). Conclusions: Plasma-based comprehensive NGS is a promising NGS method in TC; however, future validation of the clinical utility by analysis of paired tumor and plasma samples is needed.
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Affiliation(s)
- Valentina D Tarasova
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Jill Tsai
- Guardant Health, Inc., Redwood City, California, USA
| | - Jude Masannat
- Guardant Health, Inc., Redwood City, California, USA
| | | | | | - Colleen Veloski
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Sarimar Agosto Salgado
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Bryan McIver
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | | | - Christine H Chung
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida, USA
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Xu B, Viswanathan K, Ahadi MS, Ahmadi S, Alzumaili B, Bani MA, Baudin E, Behrman DB, Capelletti M, Chau NG, Chiarucci F, Chou A, Clifton-Bligh R, Coluccelli S, de Biase D, De Leo A, Dogan S, Fagin JA, Fuchs TL, Glover AR, Hadoux J, Lacroix L, Lamartina L, Lubin DJ, Luxford C, Magliocca K, Maloberti T, Mohanty AS, Najdawi F, Nigam A, Papachristos AJ, Repaci A, Robinson B, Scoazec JY, Shi Q, Sidhu S, Solaroli E, Sywak M, Tuttle RM, Untch B, Barletta JA, Al Ghuzlan A, Gill AJ, Ghossein R, Tallini G, Ganly I. Association of the Genomic Profile of Medullary Thyroid Carcinoma with Tumor Characteristics and Clinical Outcomes in an International Multicenter Study. Thyroid 2024; 34:167-176. [PMID: 37842841 PMCID: PMC10884546 DOI: 10.1089/thy.2023.0279] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Purpose: The prognostic importance of RET and RAS mutations and their relationship to clinicopathologic parameters and outcomes in medullary thyroid carcinoma (MTC) need to be clarified. Experimental Design: A multicenter retrospective cohort study was performed utilizing data from 290 patients with MTC. The molecular profile was determined and associations were examined with clinicopathologic data and outcomes. Results: RET germ line mutations were detected in 40 patients (16.3%). Somatic RET and RAS mutations occurred in 135 (46.9%) and 57 (19.8%) patients, respectively. RETM918T was the most common somatic RET mutation (n = 75). RET somatic mutations were associated with male sex, larger tumor size, advanced American Joint Committee Cancer (AJCC) stage, vascular invasion, and high International Medullary Thyroid Carcinoma Grading System (IMTCGS) grade. When compared with other RET somatic mutations, RETM918T was associated with younger age, AJCC (eighth edition) IV, vascular invasion, extrathyroidal extension, and positive margins. RET somatic or germ line mutations were significantly associated with reduced distant metastasis-free survival on univariate analysis, but there were no significant independent associations on multivariable analysis, after adjusting for tumor grade and stage. There were no significant differences in outcomes between RET somatic and RET germ line mutations, or between RETM918T and other RET mutations. Other recurrent molecular alterations included TP53 (4.2%), ARID2 (2.9%), SETD2 (2.9%), KMT2A (2.9%), and KMT2C (2.9%). Among them, TP53 mutations were associated with decreased overall survival (OS) and disease-specific survival (DSS), independently of tumor grade and AJCC stage. Conclusions: RET somatic mutations were associated with high-grade, aggressive primary tumor characteristics, and decreased distant metastatic-free survival but this relationship was not significant after accounting for tumor grade and disease stage. RETM918T was associated with aggressive primary tumors but was not independently associated with clinical outcomes. TP53 mutation may represent an adverse molecular event associated with decreased OS and DSS in MTC, but its prognostic value needs to be confirmed in future studies.
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Affiliation(s)
- Bin Xu
- Department of Pathology and Laboratory Medicine; New York, New York, USA
| | - Kartik Viswanathan
- Department of Pathology, Emory University Hospital Midtown, Atlanta, Georgia, USA
| | - Mahsa S Ahadi
- Royal North Shore Hospital and Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research; Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Sara Ahmadi
- Division of Endocrinology and Metabolism, Department of Medicine; Boston, Harvard Medical School, Boston, Massachusetts, USA
| | - Bayan Alzumaili
- Department of Pathology and Laboratory Medicine; New York, New York, USA
| | - Mohamed-Amine Bani
- Medical Pathology and Biology Department; Service d'oncologie endocrinienne; Gustave Roussy Campus Cancer, Villejuif, France
| | - Eric Baudin
- Département d'imagerie, Service d'oncologie endocrinienne; Gustave Roussy Campus Cancer, Villejuif, France
| | - David Blake Behrman
- Department of Pathology, Emory University Hospital Midtown, Atlanta, Georgia, USA
| | - Marzia Capelletti
- Department of Pathology; Brigham and Women's Hospital, Boston, Harvard Medical School, Boston, Massachusetts, USA
| | - Nicole G Chau
- Department of Pathology; Brigham and Women's Hospital, Boston, Harvard Medical School, Boston, Massachusetts, USA
| | - Federico Chiarucci
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna Medical Center; Bologna, Italy
| | - Angela Chou
- Royal North Shore Hospital and Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research; Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Roderick Clifton-Bligh
- Royal North Shore Hospital and Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research; Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Sara Coluccelli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna Medical Center; Bologna, Italy
| | - Dario de Biase
- Department of Pharmacy and Biotechnology; Bologna, Italy
| | - Antonio De Leo
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna Medical Center; Bologna, Italy
| | - Snjezana Dogan
- Department of Pathology and Laboratory Medicine; New York, New York, USA
| | - James A Fagin
- Division of Specialized Medicine; New York, New York, USA
| | - Talia L Fuchs
- Royal North Shore Hospital and Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research; Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Anthony Robert Glover
- Royal North Shore Hospital and Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Julien Hadoux
- Département d'imagerie, Service d'oncologie endocrinienne; Gustave Roussy Campus Cancer, Villejuif, France
| | - Ludovic Lacroix
- Medical Pathology and Biology Department; Service d'oncologie endocrinienne; Gustave Roussy Campus Cancer, Villejuif, France
| | - Livia Lamartina
- Département d'imagerie, Service d'oncologie endocrinienne; Gustave Roussy Campus Cancer, Villejuif, France
| | - Daniel J Lubin
- Department of Pathology, Emory University Hospital Midtown, Atlanta, Georgia, USA
| | - Catherine Luxford
- Royal North Shore Hospital and Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research; Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Kelly Magliocca
- Department of Pathology, Emory University Hospital Midtown, Atlanta, Georgia, USA
| | - Thais Maloberti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna Medical Center; Bologna, Italy
| | - Abhinita S Mohanty
- Department of Pathology and Laboratory Medicine; New York, New York, USA
| | - Fedaa Najdawi
- Department of Pathology; Brigham and Women's Hospital, Boston, Harvard Medical School, Boston, Massachusetts, USA
| | - Aradhya Nigam
- Department of Surgery; Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Alexander James Papachristos
- Royal North Shore Hospital and Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research; Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Andrea Repaci
- Division of Endocrinology and Diabetes Prevention and Care; IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Bruce Robinson
- Royal North Shore Hospital and Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research; Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Jean-Yves Scoazec
- Medical Pathology and Biology Department; Service d'oncologie endocrinienne; Gustave Roussy Campus Cancer, Villejuif, France
| | - Qiuying Shi
- Department of Pathology, Emory University Hospital Midtown, Atlanta, Georgia, USA
| | - Stan Sidhu
- Royal North Shore Hospital and Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research; Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Erica Solaroli
- Endocrinology Unit, Azienda USL di Bologna, Bologna, Italy
| | - Mark Sywak
- Royal North Shore Hospital and Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research; Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | | | - Brian Untch
- Department of Surgery; Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Justine A Barletta
- Department of Pathology; Brigham and Women's Hospital, Boston, Harvard Medical School, Boston, Massachusetts, USA
| | - Abir Al Ghuzlan
- Medical Pathology and Biology Department; Service d'oncologie endocrinienne; Gustave Roussy Campus Cancer, Villejuif, France
| | - Anthony J Gill
- Royal North Shore Hospital and Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research; Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology; Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Ronald Ghossein
- Department of Pathology and Laboratory Medicine; New York, New York, USA
| | - Giovanni Tallini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna Medical Center; Bologna, Italy
| | - Ian Ganly
- Department of Surgery; Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Assi T, Tikriti Z, Shayya A, Ibrahim R. Targeting RET mutation in medullary thyroid cancer. Pharmacogenomics 2024; 25:113-115. [PMID: 38450459 DOI: 10.2217/pgs-2023-0234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024] Open
Affiliation(s)
- Tarek Assi
- Division of International Patients Care, Gustave Roussy Cancer Campus, Villejuif, France
| | - Zamzam Tikriti
- Division of International Patients Care, Gustave Roussy Cancer Campus, Villejuif, France
| | - Annoir Shayya
- Hematology & Medical Oncology Department, Lebanese American University- Rizk Hospital, Beirut, Lebanon
| | - Rebecca Ibrahim
- Division of International Patients Care, Gustave Roussy Cancer Campus, Villejuif, France
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Marcoux P, Imeri J, Desterke C, Latsis T, Chaker D, Hugues P, Griscelli AB, Turhan AG. Impact of the overexpression of the tyrosine kinase receptor RET in the hematopoietic potential of induced pluripotent stem cells (iPSCs). Cytotherapy 2024; 26:63-72. [PMID: 37921725 DOI: 10.1016/j.jcyt.2023.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/12/2023] [Accepted: 10/05/2023] [Indexed: 11/04/2023]
Abstract
INTRODUCTION Previous studies have suggested that the tyrosine kinase receptor RET plays a significant role in the hematopoietic potential in mice and could also be used to expand cord-blood derived hematopoietic stem cells (HSCs). The role of RET in human iPSC-derived hematopoiesis has not been tested so far. METHODS To test the implication of RET on the hematopoietic potential of iPSCs, we activated its pathway with the lentiviral overexpression of RETWT or RETC634Y mutation in normal iPSCs. An iPSC derived from a patient harboring the RETC634Y mutation (iRETC634Y) and its CRISPR-corrected isogenic control iPSC (iRETCTRL) were also used. The hematopoietic potential was tested using 2D cultures and evaluated regarding the phenotype and the clonogenic potential of generated cells. RESULTS Hematopoietic differentiation from iPSCs with RET overexpression (WT or C634Y) led to a significant reduction in the number and in the clonogenic potential of primitive hematopoietic cells (CD34+/CD38-/CD49f+) as compared to control iPSCs. Similarly, the hematopoietic potential of iRETC634Y was reduced as compared to iRETCTRL. Transcriptomic analyses revealed a specific activated expression profile for iRETC634Y compared to its control with evidence of overexpression of genes which are part of the MAPK network with negative hematopoietic regulator activities. CONCLUSION RET activation in iPSCs is associated with an inhibitory activity in iPSC-derived hematopoiesis, potentially related to MAPK activation.
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Affiliation(s)
- Paul Marcoux
- INSERM UMR-S-1310, Université Paris Saclay, Villejuif, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicetre France
| | - Jusuf Imeri
- INSERM UMR-S-1310, Université Paris Saclay, Villejuif, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicetre France
| | - Christophe Desterke
- INSERM UMR-S-1310, Université Paris Saclay, Villejuif, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicetre France
| | | | - Diana Chaker
- INSERM UMR-S-1310, Université Paris Saclay, Villejuif, France; CITHERA, Centre for iPSC Therapies, INSERM UMS-45, Genopole Campus, Evry, France
| | - Patricia Hugues
- INSERM UMR-S-1310, Université Paris Saclay, Villejuif, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicetre France
| | - Annelise Bennaceur Griscelli
- INSERM UMR-S-1310, Université Paris Saclay, Villejuif, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicetre France; Department of Hematology, APHP Paris Saclay, Hôpital Bicetre, Le Kremlin Bicetre France; CITHERA, Centre for iPSC Therapies, INSERM UMS-45, Genopole Campus, Evry, France; Department of Hematology, APHP Paris Saclay, Hôpital Paul Brousse, Villejuif, France
| | - Ali G Turhan
- INSERM UMR-S-1310, Université Paris Saclay, Villejuif, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin Bicetre France; Department of Hematology, APHP Paris Saclay, Hôpital Bicetre, Le Kremlin Bicetre France; CITHERA, Centre for iPSC Therapies, INSERM UMS-45, Genopole Campus, Evry, France; Department of Hematology, APHP Paris Saclay, Hôpital Paul Brousse, Villejuif, France.
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Marcoux P, Hwang JW, Desterke C, Imeri J, Bennaceur-Griscelli A, Turhan AG. Modeling RET-Rearranged Non-Small Cell Lung Cancer (NSCLC): Generation of Lung Progenitor Cells (LPCs) from Patient-Derived Induced Pluripotent Stem Cells (iPSCs). Cells 2023; 12:2847. [PMID: 38132167 PMCID: PMC10742233 DOI: 10.3390/cells12242847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/03/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
REarranged during Transfection (RET) oncogenic rearrangements can occur in 1-2% of lung adenocarcinomas. While RET-driven NSCLC models have been developed using various approaches, no model based on patient-derived induced pluripotent stem cells (iPSCs) has yet been described. Patient-derived iPSCs hold great promise for disease modeling and drug screening. However, generating iPSCs with specific oncogenic drivers, like RET rearrangements, presents challenges due to reprogramming efficiency and genotypic variability within tumors. To address this issue, we aimed to generate lung progenitor cells (LPCs) from patient-derived iPSCs carrying the mutation RETC634Y, commonly associated with medullary thyroid carcinoma. Additionally, we established a RETC634Y knock-in iPSC model to validate the effect of this oncogenic mutation during LPC differentiation. We successfully generated LPCs from RETC634Y iPSCs using a 16-day protocol and detected an overexpression of cancer-associated markers as compared to control iPSCs. Transcriptomic analysis revealed a distinct signature of NSCLC tumor repression, suggesting a lung multilineage lung dedifferentiation, along with an upregulated signature associated with RETC634Y mutation, potentially linked to poor NSCLC prognosis. These findings were validated using the RETC634Y knock-in iPSC model, highlighting key cancerous targets such as PROM2 and C1QTNF6, known to be associated with poor prognostic outcomes. Furthermore, the LPCs derived from RETC634Y iPSCs exhibited a positive response to the RET inhibitor pralsetinib, evidenced by the downregulation of the cancer markers. This study provides a novel patient-derived off-the-shelf iPSC model of RET-driven NSCLC, paving the way for exploring the molecular mechanisms involved in RET-driven NSCLC to study disease progression and to uncover potential therapeutic targets.
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Affiliation(s)
- Paul Marcoux
- INSERM UMR-S-1310, Université Paris Saclay, 94800 Villejuif, France; (P.M.); (J.W.H.); (C.D.); (J.I.); (A.B.-G.)
- Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin Bicetre, France
| | - Jin Wook Hwang
- INSERM UMR-S-1310, Université Paris Saclay, 94800 Villejuif, France; (P.M.); (J.W.H.); (C.D.); (J.I.); (A.B.-G.)
- Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin Bicetre, France
| | - Christophe Desterke
- INSERM UMR-S-1310, Université Paris Saclay, 94800 Villejuif, France; (P.M.); (J.W.H.); (C.D.); (J.I.); (A.B.-G.)
- Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin Bicetre, France
| | - Jusuf Imeri
- INSERM UMR-S-1310, Université Paris Saclay, 94800 Villejuif, France; (P.M.); (J.W.H.); (C.D.); (J.I.); (A.B.-G.)
- Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin Bicetre, France
| | - Annelise Bennaceur-Griscelli
- INSERM UMR-S-1310, Université Paris Saclay, 94800 Villejuif, France; (P.M.); (J.W.H.); (C.D.); (J.I.); (A.B.-G.)
- Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin Bicetre, France
- APHP Paris Saclay, Department of Hematology, Hôpital Bicêtre, 94270 Le Kremlin Bicetre, France
- Center for IPSC Therapies, CITHERA, INSERM UMS-45, Genopole Campus, 91100 Evry, France
- APHP Paris Saclay, Department of Hematology, Hôpital Paul Brousse, 94800 Villejuif, France
| | - Ali G. Turhan
- INSERM UMR-S-1310, Université Paris Saclay, 94800 Villejuif, France; (P.M.); (J.W.H.); (C.D.); (J.I.); (A.B.-G.)
- Faculty of Medicine, Paris-Saclay University, 94270 Le Kremlin Bicetre, France
- APHP Paris Saclay, Department of Hematology, Hôpital Bicêtre, 94270 Le Kremlin Bicetre, France
- Center for IPSC Therapies, CITHERA, INSERM UMS-45, Genopole Campus, 91100 Evry, France
- APHP Paris Saclay, Department of Hematology, Hôpital Paul Brousse, 94800 Villejuif, France
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Laganà M, Cremaschi V, Alberti A, Vodopivec Kuri DM, Cosentini D, Berruti A. The Evolving Treatment Landscape of Medullary Thyroid Cancer. Curr Treat Options Oncol 2023; 24:1815-1832. [PMID: 37979019 PMCID: PMC10781862 DOI: 10.1007/s11864-023-01145-5] [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] [Accepted: 10/24/2023] [Indexed: 11/19/2023]
Abstract
OPINION STATEMENT Genetic assessment is crucial to address the correct treatment for advanced medullary thyroid cancer (MTC). Multi tyrosine kinase inhibitors (mTKIs) cabozantinib and vandetanib are good first line options, even vandetanib prescription is currently limited to RET mutated patients. Selective RET inhibitors such as pralsetinib could be a preferred upfront treatment in case of RET mutated MTC presenting common or gatekeeper RET mutations (e.g. M918T; V804L/M). Selpercatinib, otherwise, can be prescribed as the second line after disease progression to mTKIs. The best option for subsequent lines is to consider inclusion in clinical trials or alternatively other mTKIs such as sunitinib, sorafenib, lenvatinib, or pazopanib could be evaluated. New perspectives include next-generation RET inhibitors able to overcome resistance mechanisms responsible for disease progression to standard mTKIs and RET inhibitors, and immunotherapy for MTC presenting with high tumor mutational burden.
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Affiliation(s)
- Marta Laganà
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia at ASST Spedali Civili, 25123, Brescia, Italy
| | - Valentina Cremaschi
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia at ASST Spedali Civili, 25123, Brescia, Italy
| | - Andrea Alberti
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia at ASST Spedali Civili, 25123, Brescia, Italy.
| | - Danica M Vodopivec Kuri
- Department of Endocrinology, Diabetes, and Metabolism, University Of Alabama, 619 19Th St S, Birmingham, AL, 35249, USA
| | - Deborah Cosentini
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia at ASST Spedali Civili, 25123, Brescia, Italy
| | - Alfredo Berruti
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia at ASST Spedali Civili, 25123, Brescia, Italy
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9
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Hadoux J, Elisei R, Brose MS, Hoff AO, Robinson BG, Gao M, Jarzab B, Isaev P, Kopeckova K, Wadsley J, Führer D, Keam B, Bardet S, Sherman EJ, Tahara M, Hu MI, Singh R, Lin Y, Soldatenkova V, Wright J, Lin B, Maeda P, Capdevila J, Wirth LJ. Phase 3 Trial of Selpercatinib in Advanced RET-Mutant Medullary Thyroid Cancer. N Engl J Med 2023; 389:1851-1861. [PMID: 37870969 DOI: 10.1056/nejmoa2309719] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND Selpercatinib, a highly selective, potent RET inhibitor, has shown efficacy in advanced RET-mutant medullary thyroid cancer in a phase 1-2 trial, but its efficacy as compared with approved multikinase inhibitors is unclear. METHODS We conducted a phase 3, randomized trial comparing selpercatinib as first-line therapy with the physician's choice of cabozantinib or vandetanib (control group). Eligible patients had progressive disease documented within 14 months before enrollment. The primary end point in the protocol-specified interim efficacy analysis was progression-free survival, assessed by blinded independent central review. Crossover to selpercatinib was permitted among patients in the control group after disease progression. Treatment failure-free survival, assessed by blinded independent central review, was a secondary, alpha-controlled end point that was to be tested only if progression-free survival was significant. Among the other secondary end points were overall response and safety. RESULTS A total of 291 patients underwent randomization. At a median follow-up of 12 months, median progression-free survival as assessed by blinded independent central review was not reached in the selpercatinib group and was 16.8 months (95% confidence interval [CI], 12.2 to 25.1) in the control group (hazard ratio for disease progression or death, 0.28; 95% CI, 0.16 to 0.48; P<0.001). Progression-free survival at 12 months was 86.8% (95% CI, 79.8 to 91.6) in the selpercatinib group and 65.7% (95% CI, 51.9 to 76.4) in the control group. Median treatment failure-free survival as assessed by blinded independent central review was not reached in the selpercatinib group and was 13.9 months in the control group (hazard ratio for disease progression, discontinuation due to treatment-related adverse events, or death, 0.25; 95% CI, 0.15 to 0.42; P<0.001). Treatment failure-free survival at 12 months was 86.2% (95% CI, 79.1 to 91.0) in the selpercatinib group and 62.1% (95% CI, 48.9 to 72.8) in the control group. The overall response was 69.4% (95% CI, 62.4 to 75.8) in the selpercatinib group and 38.8% (95% CI, 29.1 to 49.2) in the control group. Adverse events led to a dose reduction in 38.9% of the patients in the selpercatinib group, as compared with 77.3% in the control group, and to treatment discontinuation in 4.7% and 26.8%, respectively. CONCLUSIONS Selpercatinib treatment resulted in superior progression-free survival and treatment failure-free survival as compared with cabozantinib or vandetanib in patients with RET-mutant medullary thyroid cancer. (Funded by Loxo Oncology, a subsidiary of Eli Lilly; LIBRETTO-531 ClinicalTrials.gov number, NCT04211337.).
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Affiliation(s)
- Julien Hadoux
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Rossella Elisei
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Marcia S Brose
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Ana O Hoff
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Bruce G Robinson
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Ming Gao
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Barbara Jarzab
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Pavel Isaev
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Katerina Kopeckova
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Jonathan Wadsley
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Dagmar Führer
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Bhumsuk Keam
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Stéphane Bardet
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Eric J Sherman
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Makoto Tahara
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Mimi I Hu
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Ravinder Singh
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Yan Lin
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Victoria Soldatenkova
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Jennifer Wright
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Boris Lin
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Patricia Maeda
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Jaume Capdevila
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
| | - Lori J Wirth
- From the Service d'oncologie endocrinienne, département d'imagerie, Gustave Roussy and ENDOCAN-TUTHYREF Network, Villejuif (J.H.), and the Nuclear Medicine Department and Thyroid Unit, Centre François Baclesse, Caen (S.B.) - both in France; the Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy (R.E.); the Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia (M.S.B.); the Department of Endocrinology, Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo, and Instituto D'Or de Pesquisa e Ensino - both in São Paulo (A.O.H.); Sydney Medical School, University of Sydney, Sydney (B.G.R.); the Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China (M.G.); the Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska Curie National Research Institute of Oncology, Gliwice Branch, Poland (B.J.); Federal State Institution Medical Radiology Research Center, Obninsk, Russia (P.I.); the Department of Oncology, 2nd Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic (K.K.); the Clinical Oncology Department, Weston Park Cancer Center, NHS Foundation Trust, Sheffield, United Kingdom (J.W.); the Department of Endocrinology Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany (D.F.); the Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (B.K.); the Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York (E.J.S.); the Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan (M.T.); the Endocrine Neoplasia and Hormonal Disorders Department, University of Texas M.D. Anderson Cancer Center, Houston (M.I.H.); Eli Lilly, Indianapolis (R.S., Y.L., V.S., J.W., B.L., P.M.); the Medical Oncology Department, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona (J.C.); and the Cancer Center, Massachusetts General Hospital, Boston (L.J.W.)
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10
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Zhang L, Feng Q, Wang J, Tan Z, Li Q, Ge M. Molecular basis and targeted therapy in thyroid cancer: Progress and opportunities. Biochim Biophys Acta Rev Cancer 2023; 1878:188928. [PMID: 37257629 DOI: 10.1016/j.bbcan.2023.188928] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/02/2023]
Abstract
Thyroid cancer (TC) is the most prevalent endocrine malignant tumor. Surgery, chemotherapy, radiotherapy, and radioactive iodine (RAI) therapy are the standard TC treatment modalities. However, recurrence or tumor metastasis remains the main challenge in the management of anaplastic thyroid cancer (ATC) and radioiodine (RAI) radioactive iodine-refractory differentiated thyroid cancer (RR-DTC). Several multi-tyrosine kinase inhibitors (MKIs), or immune checkpoint inhibitors in combination with MKIs, have emerged as novel therapies for controlling the progression of DTC, medullary thyroid cancer (MTC), and ATC. Here, we discuss and summarize the molecular basis of TC, review molecularly targeted therapeutic drugs in clinical research, and explore potentially novel molecular therapeutic targets. We focused on the evaluation of current and recently emerging tyrosine kinase inhibitors approved for systemic therapy for TC, including lenvatinib, sorafenib and cabozantinib in DTC, vandetanib, cabozantinib, and RET-specific inhibitor (selpercatinib and pralsetinib) in MTC, combination dabrafenib with trametinib in ATC. In addition, we also discuss promising treatments that are in clinical trials and may be incorporated into clinical practice in the future, briefly describe the resistance mechanisms of targeted therapies, emphasizing that personalized medicine is critical to the design of second-line therapies.
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Affiliation(s)
- Lizhuo Zhang
- Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang 310014, China; Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, Zhejiang 310014, China
| | - Qingqing Feng
- Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China.
| | - Jiafeng Wang
- Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang 310014, China; Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, Zhejiang 310014, China
| | - Zhuo Tan
- Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang 310014, China; Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, Zhejiang 310014, China.
| | - Qinglin Li
- The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China.
| | - Minghua Ge
- Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang 310014, China; Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, Zhejiang 310014, China.
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11
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Yin S, Lan W, Hou X, Liu Z, Xue H, Wang C, Tang GL, Cao C. Trioxacarcin A Interactions with G-Quadruplex DNA Reveal Its Potential New Targets as an Anticancer Agent. J Med Chem 2023; 66:6798-6810. [PMID: 37154782 DOI: 10.1021/acs.jmedchem.3c00178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Trioxacarcin (TXN) A was reported to be an anticancer agent through alkylation of dsDNA. G-quadruplex DNA (G4-DNA) is frequently formed in the promoter regions of oncogenes and the ends of telomerase genes, considered as promising drug targets for anticancer therapy. There are no reports about TXN A interactions with G4-DNA. Here, we tested TXN A's interactions with several G4-DNA oligos with parallel, antiparallel, or hybrid folding, respectively. We demonstrated that TXN A preferred to alkylate one flexible guanine in the loops of parallel G4-DNA. The position of the alkylated guanine is in favor of interactions of G4-DNA with TXN A. The structure of TXN A covalently bound RET G4-DNA indicated that TXN A alkylation on RET G4-DNA stabilizes the G4-DNA conformation. These studies opened a new window of how TXN A interacted with G4-DNA, which might hint a new mode of its function as an anticancer agent.
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Affiliation(s)
- Shaowen Yin
- State Key Laboratory of Bioorganic and Natural Product Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, 345 Lingling Road, Shanghai 200032, China
- University of Chinese Academy of Science, No. 19A, Yuquan Road, Shijingshan District, Beijing 100049, China
| | - Wenxian Lan
- The Core Facility Centre of CAS Center for Excellence in Molecular Plant Sciences, 300 Fengling Road, Shanghai 200032, China
| | - Xianfeng Hou
- State Key Laboratory of Bioorganic and Natural Product Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, 345 Lingling Road, Shanghai 200032, China
| | - Zhijun Liu
- National Center for Protein Science in Shanghai, Shanghai Advanced Research Institute, Chinese Academy of Sciences, 333 Kaike Road, Shanghai 201210, China
| | - Hongjuan Xue
- National Center for Protein Science in Shanghai, Shanghai Advanced Research Institute, Chinese Academy of Sciences, 333 Kaike Road, Shanghai 201210, China
| | - Chunxi Wang
- State Key Laboratory of Bioorganic and Natural Product Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, 345 Lingling Road, Shanghai 200032, China
| | - Gong-Li Tang
- State Key Laboratory of Bioorganic and Natural Product Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, 345 Lingling Road, Shanghai 200032, China
| | - Chunyang Cao
- State Key Laboratory of Bioorganic and Natural Product Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, 345 Lingling Road, Shanghai 200032, China
- University of Chinese Academy of Science, No. 19A, Yuquan Road, Shijingshan District, Beijing 100049, China
- Collaborative Innovation Center of Chemistry for Life Sciences, Chinese Academy of Sciences, 345 Lingling Road, Shanghai 200032, China
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12
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Wirth LJ, Brose MS, Elisei R, Capdevila J, Hoff AO, Hu MI, Tahara M, Robinson B, Gao M, Xia M, Maeda P, Sherman E. LIBRETTO-531: a phase III study of selpercatinib in multikinase inhibitor-naïve RET-mutant medullary thyroid cancer. Future Oncol 2022; 18:3143-3150. [PMID: 35969032 PMCID: PMC10652291 DOI: 10.2217/fon-2022-0657] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/27/2022] [Indexed: 11/21/2022] Open
Abstract
Selpercatinib is a first-in-class, highly selective and potent, central nervous system-active RET kinase inhibitor. In the phase I/II trial, selpercatinib demonstrated clinically meaningful antitumor activity with manageable toxicity in heavily pre-treated and treatment-naive patients with RET-mutant medullary thyroid cancer (MTC). LIBRETTO-531 (NCT04211337) is a multicenter, open-label, randomized, controlled, phase III trial comparing selpercatinib to cabozantinib or vandetanib in patients with advanced/metastatic RET-mutant MTC. The primary objective is to compare progression-free survival (per RECIST 1.1) by blinded independent central review of patients with progressive, advanced, multikinase inhibitor-naive, RET-mutant MTC treated with selpercatinib versus cabozantinib or vandetanib. Key secondary objectives are to compare other efficacy outcomes (per RECIST 1.1) and tolerability of selpercatinib versus cabozantinib or vandetanib.
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Affiliation(s)
- Lori J Wirth
- Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Marcia S Brose
- Sidney Kimmel Cancer Center of Jefferson University Health, Philadelphia, PA 19107, USA
| | - Rossella Elisei
- Endocrine Unit, Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - Jaume Capdevila
- Vall Hebron Institute of Oncology, IOB Quirón-Teknon, Barcelona, Spain
| | - Ana O Hoff
- Department of Endocrinology, Endocrine Oncology Unit, Instituto de Cancer do Estado de Sao Paulo, Sao Paulo, Brazil
| | - Mimi I Hu
- Department of Endocrine Neoplasia & Hormonal Disorders, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Makoto Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Ming Gao
- Tianjin Medical University Cancer Institute & Hospital, Tianjin Union Medical Center, National Clinical Research Center for Cancer, Tianjin, China
| | - Meng Xia
- Eli Lilly & Company, Indianapolis, IN 46285, USA
| | | | - Eric Sherman
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, Manhattan, NY 10065, USA
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13
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Haddad RI, Bischoff L, Ball D, Bernet V, Blomain E, Busaidy NL, Campbell M, Dickson P, Duh QY, Ehya H, Goldner WS, Guo T, Haymart M, Holt S, Hunt JP, Iagaru A, Kandeel F, Lamonica DM, Mandel S, Markovina S, McIver B, Raeburn CD, Rezaee R, Ridge JA, Roth MY, Scheri RP, Shah JP, Sipos JA, Sippel R, Sturgeon C, Wang TN, Wirth LJ, Wong RJ, Yeh M, Cassara CJ, Darlow S. Thyroid Carcinoma, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2022; 20:925-951. [PMID: 35948029 DOI: 10.6004/jnccn.2022.0040] [Citation(s) in RCA: 140] [Impact Index Per Article: 70.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Differentiated thyroid carcinomas is associated with an excellent prognosis. The treatment of choice for differentiated thyroid carcinoma is surgery, followed by radioactive iodine ablation (iodine-131) in select patients and thyroxine therapy in most patients. Surgery is also the main treatment for medullary thyroid carcinoma, and kinase inhibitors may be appropriate for select patients with recurrent or persistent disease that is not resectable. Anaplastic thyroid carcinoma is almost uniformly lethal, and iodine-131 imaging and radioactive iodine cannot be used. When systemic therapy is indicated, targeted therapy options are preferred. This article describes NCCN recommendations regarding management of medullary thyroid carcinoma and anaplastic thyroid carcinoma, and surgical management of differentiated thyroid carcinoma (papillary, follicular, Hürthle cell carcinoma).
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Affiliation(s)
| | | | - Douglas Ball
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | - Paxton Dickson
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | - Quan-Yang Duh
- UCSF Helen Diller Family Comprehensive Cancer Center
| | | | | | | | | | - Shelby Holt
- UT Southwestern Simmons Comprehensive Cancer Center
| | - Jason P Hunt
- Huntsman Cancer Institute at the University of Utah
| | | | | | | | - Susan Mandel
- Abramson Cancer Center at the University of Pennsylvania
| | - Stephanie Markovina
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | - Rod Rezaee
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | - Mara Y Roth
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | | | - Jennifer A Sipos
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | - Cord Sturgeon
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | - Michael Yeh
- UCLA Jonsson Comprehensive Cancer Center; and
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14
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Milicevic S, Krajc M, Blatnik A, Peric B. Medullary Thyroid Carcinoma and Associated Endocrinopathies in Slovenia from 1995 to 2021. Life (Basel) 2022; 12:1091. [PMID: 35888179 PMCID: PMC9320156 DOI: 10.3390/life12071091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Medullary thyroid cancer (MTC) is a rare endocrine tumour that is sporadic in 75% of cases and occurs as a part of inherited cancer syndromes in approximately 25% of cases. The aim of this study was to determine the frequency and type of RET pathogenic variants (PVs) in the Slovenian MTC patient population diagnosed between 1995 and 2021 and to elucidate the full range of associated endocrinopathies. METHODS A retrospective analysis of medical records of 266 MTC patients and their relatives seen in a tertiary centre between 1995 and 2021 was performed. Sequence analysis of exons 10, 11, 13, 14, 15, and 16 of the RET gene was analysed in most patients using Sanger sequencing. From 2017, the entire sequence of RET gene was analysed in most patients using targeted next-generation sequencing. RESULTS Germline PVs in the RET proto-oncogene were identified in 21.6% probands from 21 different MTC families. Of their tested relatives, 65% (67/103) were RET-positive and 35% (36/103) were RET-negative. PVs were detected in codon 618 and codon 634 in 28.6%, and in codon 790 in 23.8%. The RET-positive group consisted of 52 MTC patients, 13 patients with C cell hyperplasia and 2 individuals with neither. Associated endocrinopathies were diagnosed in 8/21 families: primary hyperparathyroidism (PHPT) in six families and pheochromocytoma (PHEO) in five families. In 62% of RET-positive families (13/21), no associated endocrinopathies were diagnosed. PHEO was most commonly associated with C634R (6/13) and PHPT with C634R (4/7). Hirschsprung's disease appeared in one patient with RET PV in codon 618. Based on data from the Cancer Registry of Republic of Slovenia, only individual cases of common cancers with well understood environmental risk factors were discovered; lung cancer in 2/21 of families, papillary thyroid cancer in 3/21 of families, cutaneous melanoma in 2/21 of families, cervical cancer in 1/21 families, and lymphoma in 1/21 families. CONCLUSIONS Analysis of prospectively collected MTC cases during a 27-year period revealed that 21.6% of Slovenian patients are RET PV carriers. Sixty-two percent of families had none of the associated endocrinopathies, confirming the thesis that FMTC is the most common presentation. This could suggest using risk-stratified management approaches when screening for PHEO and PHPT in RET PV carriers. However, more studies are needed to evaluate potential genetic risk modifiers as well as safety, improved quality of life, and medical cost reduction in the case of a patient-oriented approach.
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Affiliation(s)
- Sara Milicevic
- Institute of Oncology Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia; (S.M.); (M.K.); (A.B.)
| | - Mateja Krajc
- Institute of Oncology Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia; (S.M.); (M.K.); (A.B.)
- Faculty of Medicine, University of Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia
| | - Ana Blatnik
- Institute of Oncology Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia; (S.M.); (M.K.); (A.B.)
- Faculty of Medicine, University of Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia
| | - Barbara Peric
- Institute of Oncology Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia; (S.M.); (M.K.); (A.B.)
- Faculty of Medicine, University of Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia
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15
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Lockridge R, Bedoya S, Allen T, Widemann BC, Akshintala S, Glod J, Wiener L. Psychosocial Characteristics and Experiences in Patients with Multiple Endocrine Neoplasia Type 2 (MEN2) and Medullary Thyroid Carcinoma (MTC). CHILDREN (BASEL, SWITZERLAND) 2022; 9:774. [PMID: 35740711 PMCID: PMC9221799 DOI: 10.3390/children9060774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/11/2022] [Accepted: 05/21/2022] [Indexed: 01/09/2023]
Abstract
Multiple Endocrine Neoplasia type 2 (MEN2) is a genetic cancer syndrome for which there are limited data pertaining to the quality of life and psychosocial experiences of persons affected. Medullary thyroid carcinoma (MTC) is a rare disease of the thyroid gland often associated with MEN2. MTC often progresses slowly and may present with a myriad of physical symptoms including hair loss, sleep disturbance, fatigue, weight changes, heart palpitations, and constipation or diarrhea. Like other cancers or rare, inheritable illnesses, patients with MEN2 and MTC may be at risk for psychosocial stressors. The current, cross-sectional study administered a structured psychosocial interview and The Distress Thermometer/Problem Checklist to 63 patients with MEN2 and MTC and their caregivers. Despite reports of overall good health, 46% of adults and 44% of youth reported that pain interferes with their daily life; 53% of adults and 59% of youth reported that pain interferes with their mood. Pediatric patients frequently reported experiencing attention challenges (50%) and difficulty concentrating (65%). Parents reported that mood shifts and becoming upset easily were the most prevalent concerns for their children. The most frequent need for services included education about MTC, treatment and research participation, and the opportunity to meet others with MTC.
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Affiliation(s)
- Robin Lockridge
- Clinical Research Directorate (CRD), Frederick National Library for Cancer Research, Frederick, MD 21701, USA;
| | - Sima Bedoya
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (S.B.); (T.A.); (B.C.W.); (S.A.); (J.G.)
| | - Taryn Allen
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (S.B.); (T.A.); (B.C.W.); (S.A.); (J.G.)
| | - Brigitte C. Widemann
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (S.B.); (T.A.); (B.C.W.); (S.A.); (J.G.)
| | - Srivandana Akshintala
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (S.B.); (T.A.); (B.C.W.); (S.A.); (J.G.)
| | - John Glod
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (S.B.); (T.A.); (B.C.W.); (S.A.); (J.G.)
| | - Lori Wiener
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; (S.B.); (T.A.); (B.C.W.); (S.A.); (J.G.)
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16
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Management and Long-Term Follow-Up of Hyperparathyroidism in Multiple Endocrine Neoplasia Type 1: Single Center Experience. J Clin Med 2022; 11:jcm11071967. [PMID: 35407574 PMCID: PMC8999236 DOI: 10.3390/jcm11071967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/13/2022] [Accepted: 03/28/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Primary hyperparathyroidism (PHPT) in the most common and earliest manifestation of multiple endocrine neoplasia type-1 (MEN1). Epidemiological data have been reported in MEN1 patients but data on long-term follow-up focusing on PHPT are scarce. Methods: In this retrospective cohort study, we included patients diagnosed with MEN1-related PHPT that were under regular follow-up in our institution. Results: Data on 68 patients (39 males), with a mean age at MEN1-diagnosis of 39 ± 13.06 years, were analyzed. Pancreatic neuroendocrine tumors were encountered in 82% (71% nonsecreting) followed by pituitary adenomas in 66% (49% nonsecreting). Mean age at PHPT diagnosis was 35.2 ± 4.0 years. Parathyroidectomy was performed in 57 patients (82.3%), of whom 56% achieved long-term remission, while 12.2% and 31.5% had persistent and recurrent disease, respectively (median follow-up of 4 years; range 1–21 years). Cinacalcet restored serum calcium levels in 33.8%, both as first and as a second line treatment. Permanent hypoparathyroidism occurred in 19.2%. MEN1 pathogenic variants were identified in 77.2% of the tested individuals, but no genotype-phenotype associations were reported. Conclusions: MEN1-related PHPT involves a multiglandular disease and its management remains a therapeutic challenge, as recurrent disease can develop even after 20 years of follow-up. Prolonged follow-up of these patients at referral centers is critical for their optimal management.
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Shi P, Liu Y, Yang D, Wu Y, Zhang L, Jing S, Shi H, Geng C. CircRNA ZNF609 promotes the growth and metastasis of thyroid cancer in vivo and in vitro by downregulating miR-514a-5p. Bioengineered 2022; 13:4372-4384. [PMID: 35135416 PMCID: PMC8973772 DOI: 10.1080/21655979.2022.2033015] [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] [Indexed: 02/08/2023] Open
Abstract
Thyroid cancer (TC) often manifests in the form of a painless cervical mass or nodule and continues to increase in incidence. Currently, much less is known about its pathogenesis in TC cells. This study sought to figure out what role the circular RNA (circRNA) ZNF609/miR-514a-5p might play in TC development and metastasis. In this study, the detection of circ-ZNF609 and miR-514a-5p expressions was carried out by qRT-PCR in TC cell lines. Cell proliferation assessment is employed by cell counting kit-8 (CCK-8) assay, colony formation, Western blot and immunofluorescence. Cell invasion and migration measurement were conducted applying wound healing and transwell. The relationship between circ-ZNF609 and miR-514a-5p was subjected to prediction with bioinformatics analysis and validated with the aid of luciferase reporter assay. Furthermore, xenograft animal experiment was adopted to confirm the role of circ-ZNF609/miR-514a-5p in TC in vivo. The data indicated that circ-ZNF609 was highly expressed, while miR-514a-5p was downregulated in TC cells. Circ-ZNF609 knockdown prevented the malignant biological behaviors of TPC-1 and IHH-4 cells. Besides, circ-ZNF609 sponged miR-514a-5p and miR-514a-5p knockdown reversed the suppressed impacts of circ-ZNF609 knockdown on TC cell malignant biological behaviors. In addition, the silence of circ-ZNF6091 significantly repressed, whereas miR-514a-5p silencing promoted TC tumorigenesis in vivo. The findings highlighted the importance of circ-ZNF609 function in facilitating TC cell development and metastasis in vitro and in vivo via binding to miR-514a-5p.
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Affiliation(s)
- Ping Shi
- Department of Otolaryngology Head and Neck Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China
| | - Yan Liu
- Department of Otolaryngology Head and Neck Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China
| | - Dongqiang Yang
- Department of Radiological Intervention, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China
| | - Yanzhao Wu
- Department of Otolaryngology Head and Neck Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China
| | - Lan Zhang
- Department of Otolaryngology Head and Neck Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China
| | - Shanghua Jing
- Department of Otolaryngology Head and Neck Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China
| | - Huijing Shi
- Department of Otolaryngology Head and Neck Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China
| | - Cuizhi Geng
- Department of General Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China
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Pitsava G, Stratakis CA, Faucz FR. PRKAR1A and Thyroid Tumors. Cancers (Basel) 2021; 13:cancers13153834. [PMID: 34359735 PMCID: PMC8345073 DOI: 10.3390/cancers13153834] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary In 2021 it is estimated that there will be 44,280 new cases of thyroid cancer in the United States and the incidence rate is higher in women than in men by almost 3 times. Well-differentiated thyroid cancer is the most common subtype of thyroid cancer and includes follicular (FTC) and papillary (PTC) carcinomas. Over the last decade, researchers have been able to better understand the molecular mechanisms involved in thyroid carcinogenesis, identifying genes including but not limited to RAS, BRAF, PAX8/PPARγ chromosomal rearrangements and others, as well as several tumor genes involved in major signaling pathways regulating cell cycle, differentiation, growth, or proliferation. Patients with Carney complex (CNC) have increased incidence of thyroid tumors, including cancer, yet little is known about this association. CNC is a familial multiple neoplasia and lentiginosis syndrome cause by inactivating mutations in the PRKAR1A gene which encodes the regulatory subunit type 1α of protein kinase A. This work summarizes what we know today about PRKAR1A defects in humans and mice and their role in thyroid tumor development, as the first such review on this issue. Abstract Thyroid cancer is the most common type of endocrine malignancy and the incidence is rapidly increasing. Follicular (FTC) and papillary thyroid (PTC) carcinomas comprise the well-differentiated subtype and they are the two most common thyroid carcinomas. Multiple molecular genetic and epigenetic alterations have been identified in various types of thyroid tumors over the years. Point mutations in BRAF, RAS as well as RET/PTC and PAX8/PPARγ chromosomal rearrangements are common. Thyroid cancer, including both FTC and PTC, has been observed in patients with Carney Complex (CNC), a syndrome that is inherited in an autosomal dominant manner and predisposes to various tumors. CNC is caused by inactivating mutations in the tumor-suppressor gene encoding the cyclic AMP (cAMP)-dependent protein kinase A (PKA) type 1α regulatory subunit (PRKAR1A) mapped in chromosome 17 (17q22–24). Growth of the thyroid is driven by the TSH/cAMP/PKA signaling pathway and it has been shown in mouse models that PKA activation through genetic ablation of the regulatory subunit Prkar1a can cause FTC. In this review, we provide an overview of the molecular mechanisms contributing to thyroid tumorigenesis associated with inactivation of the RRKAR1A gene.
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Affiliation(s)
- Georgia Pitsava
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institutes of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA;
- Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Constantine A. Stratakis
- Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Fabio R. Faucz
- Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA;
- Correspondence: ; Tel.: +1-301-451-7177
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Pavlidis E, Sapalidis K, Chatzinikolaou F, Kesisoglou I. Medullary thyroid cancer: molecular factors, management and treatment. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 61:681-686. [PMID: 33817709 PMCID: PMC8112777 DOI: 10.47162/rjme.61.3.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Medullary thyroid cancer (MTC) is an infrequent neuroendocrine tumor, which amounts to 3–5% of all thyroid malignancies. Approximately 75–80% of MTCs are sporadic neoplasms. The rest of 20–25% are familial cases that belong to multiple endocrine neoplasia (MEN) syndromes, specifically MEN2 and MEN3. These cases of familial MTC are attributed to an activating germline mutation of a tyrosine kinase receptor gene, the rearranged during transfection (RET) proto-oncogene, located on chromosome 10q11.21. These mutations are also found in some cases of sporadic MTC. This review sets forth in summary the accepted guidelines and approaches regarding diagnosis, management, and treatment of MTC. Surgical resection is the standard care, and an early, prophylactic intervention is performed in genetic cases. Further investigation and understanding of the molecular pathways involved in the growth and advancement of MTC is required in order to provide efficient therapy in cases of progressive disease.
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Affiliation(s)
- Efstathios Pavlidis
- 3rd Department of Surgery, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece;
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20
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Fancelli S, Caliman E, Mazzoni F, Brugia M, Castiglione F, Voltolini L, Pillozzi S, Antonuzzo L. Chasing the Target: New Phenomena of Resistance to Novel Selective RET Inhibitors in Lung Cancer. Updated Evidence and Future Perspectives. Cancers (Basel) 2021; 13:cancers13051091. [PMID: 33806299 PMCID: PMC7961559 DOI: 10.3390/cancers13051091] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/13/2021] [Accepted: 02/26/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary REarranged during Transfection (RET) is an emerging target for several types of cancer, including non-small cell lung cancer (NSCLC). The recent U.S. FDA approval of pralsetinib and selpercatinib raises issues regarding the emergence of secondary mutations and amplifications involved in parallel signaling pathways and receptors, liable for resistance mechanisms. The aim of this review is to explore recent knowledge on RET resistance in NSCLC in pre-clinic and in clinical settings and accordingly, the state-of-the-art in new drugs or combination of drugs development. Abstract The potent, RET-selective tyrosine kinase inhibitors (TKIs) pralsetinib and selpercatinib, are effective against the RET V804L/M gatekeeper mutants, however, adaptive mutations that cause resistance at the solvent front RET G810 residue have been found, pointing to the need for the development of the next-generation of RET-specific TKIs. Also, as seen in EGFR- and ALK-driven NSCLC, the rising of the co-occurring amplifications of KRAS and MET could represent other escaping mechanisms from direct inhibition. In this review, we summarize actual knowledge on RET fusions, focusing on those involved in NSCLC, the results of main clinical trials of approved RET-inhibition drugs, with particular attention on recent published results of selective TKIs, and finally, pre-clinical evidence regarding resistance mechanisms and suggestion on hypothetical and feasible drugs combinations and strategies viable in the near future.
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Affiliation(s)
- Sara Fancelli
- Medical Oncology Unit, Careggi University Hospital, 50134 Florence, Italy; (S.F.); (E.C.); (F.M.); (M.B.); (S.P.)
| | - Enrico Caliman
- Medical Oncology Unit, Careggi University Hospital, 50134 Florence, Italy; (S.F.); (E.C.); (F.M.); (M.B.); (S.P.)
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
| | - Francesca Mazzoni
- Medical Oncology Unit, Careggi University Hospital, 50134 Florence, Italy; (S.F.); (E.C.); (F.M.); (M.B.); (S.P.)
| | - Marco Brugia
- Medical Oncology Unit, Careggi University Hospital, 50134 Florence, Italy; (S.F.); (E.C.); (F.M.); (M.B.); (S.P.)
| | - Francesca Castiglione
- Pathological Histology and Molecular Diagnostics Unit, Careggi University Hospital, 50134 Florence, Italy;
| | - Luca Voltolini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
- Thoraco-Pulmonary Surgery Unit, Careggi University Hospital, 50134 Florence, Italy
| | - Serena Pillozzi
- Medical Oncology Unit, Careggi University Hospital, 50134 Florence, Italy; (S.F.); (E.C.); (F.M.); (M.B.); (S.P.)
| | - Lorenzo Antonuzzo
- Medical Oncology Unit, Careggi University Hospital, 50134 Florence, Italy; (S.F.); (E.C.); (F.M.); (M.B.); (S.P.)
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
- Correspondence: ; Tel.: +39-055-7948406
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21
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Valiveru RC, Agarwal G, Agrawal V, Mayilvaganan S, Chand G, Mishra A, Agarwal A, Mishra SK, Bhatia E. Hereditary Medullary Thyroid Carcinoma: Genotype, Phenotype and Outcomes in a North Indian Cohort. World J Surg 2021; 45:1785-1793. [PMID: 33606078 DOI: 10.1007/s00268-021-05993-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Aggressiveness of hereditary medullary thyroid carcinoma (hMTC) has been conventionally described to correlate with American Thyroid Association (ATA) risk groups based on RET mutations. Recent evidence increasingly contradicts this notion. We studied the RET genotype and its correlation with disease phenotype and survival outcomes in a cohort of hMTC patients. METHODS In a retrospective cohort of 55 hMTC patients from 23 families treated at a north Indian tertiary care institute over 15-years, RET genotype was correlated with disease phenotype (clinical, biochemical, and pathological attributes) and outcomes in terms of biochemical cure (normalization of serum calcitonin), structural cure, overall survival (OS) and disease specific survival (DSS). RESULTS Forty-nine patients had Multiple Endocrine Neoplasia (MEN)-type 2A syndrome, 02 had MEN-2B, and 4 had familial MTC. Two patients belonged to highest ATA risk, 41 to high-risk, and 12 to moderate risk categories. Age of the patients or stage of disease at presentation did not differ significantly between the ATA risk groups. Though the baseline serum calcitonin was significantly higher in highest risk category, the biochemical cure rates were not significantly different. At a median follow up of 48 months (Inter-quartile range 18-84, range 12-192) structural cure rates in ATA moderate and high risk groups were significantly higher than highest risk group (p = 0.04). No significant difference in OS between the three ATA groups of hMTC among the patients who underwent surgical treatment was observed (p = 0.098). CONCLUSIONS The ATA moderate and high risk groups have better structural cure rates compared to ATA highest risk group. The biochemical cure and overall survival rates did not significantly differ between ATA risk-groups, and were impacted by the disease stage at presentation. The current ATA risk-groups do not reliably predict the outcomes in terms of biochemical cure and survival in hMTC patients.
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Affiliation(s)
- Ramya C Valiveru
- Department of Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, UP, 226014, India
| | - Gaurav Agarwal
- Department of Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, UP, 226014, India.
| | - Vinita Agrawal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, UP, 226014, India
| | - Sabaretnam Mayilvaganan
- Department of Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, UP, 226014, India
| | - Gyan Chand
- Department of Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, UP, 226014, India
| | - Anjali Mishra
- Department of Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, UP, 226014, India
| | - Amit Agarwal
- Department of Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, UP, 226014, India
| | - Saroj Kanta Mishra
- Department of Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, UP, 226014, India
| | - Eesh Bhatia
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, UP, 226014, India
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22
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Brandenburg T, Tiedje V, Muchalla P, Theurer S, Weber F, Schmid KW, Dralle H, Führer D. Continued Discontinuation of TKI Treatment in Medullary Thyroid Carcinoma - Lessons From Individual Cases With Long-Term Follow-Up. Front Endocrinol (Lausanne) 2021; 12:718418. [PMID: 34659114 PMCID: PMC8511790 DOI: 10.3389/fendo.2021.718418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The tyrosine kinase inhibitors (TKI) vandetanib and cabozantinib are approved as targeted therapies in advanced medullary thyroid carcinoma (MTC) with symptoms or high tumour burden. Only recently, toxicity in long-time TKI usage was analysed. However, little is known about the impact of TKI discontinuation on MTC disease course after longer-term therapy. Here, we report our experience in a series of 7 MTC patients with vandetanib treatment of up to 87 months followed by discontinuation for concerns of toxicity or due to side-effects. The discontinuation of TKI therapy is a relevant clinical scenario. To our knowledge we present the largest single center series on an important aspect of TKI management. METHODS Retrospective analysis of MTC patients with continued discontinuation of vandetanib treatment in a tertiary referral endocrine tumour centre. Analysis included a review of patients' records for TKI indication, and treatment response as well indications for continued TKI discontinuation and follow-up by clinical assessment, calcitonin and CEA doubling times as well as imaging (ultrasound, CT). RESULTS Seven MTC patients [6 sporadic MTC, 1 Multiple Endocrine Neplasie Type 2a (MEN2a)] with previous vandetanib treatment (median: 41 months; range 7-87 months) and continued TKI discontinuation were identified out of 161 analysed MTC files. TKI treatment was initiated due to high tumour burden and symptoms or RECIST (Response Evaluation Criteria In Solid Tumors) progression in all patients. Two patients (29%) remained stable after discontinuation of vandetanib until now (follow-up of 47 and 61 months). Both patients had been on TKI therapy for 73 and 58 months. Five patients (71%) developed progressive disease after TKI discontinuation. In 2 patients, vandetanib was restarted after 45 and 52 months resulting again in disease control. One patient was enrolled in a new RET kinase inhibitor trial after 45 months of vandetanib discontinuation. Two patients declined restart of treatment due to mental health issues leading to discontinuation of vandetanib in the first place (after 7 and 38 months of treatment) and both patients died of rapidly progressive disease. At time points of tumour progression, calcitonin-doubling time (CDT) was < 2 years in all patients. CONCLUSION This case series suggests that discontinuation of long-term vandetanib treatment with documented stable disease does not automatically result in rapid disease progression but may be followed by prolonged "TKI free" stable disease in individual patients. Analysis of calcitonin and CDT during discontinuation is indicated as it will unmask tumour progression earlier than imaging. Restart with the same TKI is possible in case of progression.
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Affiliation(s)
- Tim Brandenburg
- Department of Endocrinology, Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University of Duisburg-Essen, Essen, Germany
| | - Vera Tiedje
- Department of Endocrinology, Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University of Duisburg-Essen, Essen, Germany
- Department of Medicine and Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Philipp Muchalla
- Department of Endocrinology, Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University of Duisburg-Essen, Essen, Germany
| | - Sarah Theurer
- Institute of Pathology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Frank Weber
- Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Kurt Werner Schmid
- Institute of Pathology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Henning Dralle
- Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dagmar Führer
- Department of Endocrinology, Diabetology and Metabolism, Endocrine Tumour Center at West German Cancer Center, University of Duisburg-Essen, Essen, Germany
- *Correspondence: Dagmar Führer,
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23
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Lupo MA, Walts AE, Sistrunk JW, Giordano TJ, Sadow PM, Massoll N, Campbell R, Jackson SA, Toney N, Narick CM, Kumar G, Mireskandari A, Finkelstein SD, Bose S. Multiplatform molecular test performance in indeterminate thyroid nodules. Diagn Cytopathol 2020; 48:1254-1264. [PMID: 32767735 PMCID: PMC7754490 DOI: 10.1002/dc.24564] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Approximately 25% of thyroid nodule fine-needle aspirates (FNAs) have cytology that is indeterminate for malignant disease. Accurate risk stratification of these FNAs with ancillary testing would reduce unnecessary thyroid surgery. METHODS We evaluated the performance of an ancillary multiplatform test (MPTX) that has three diagnostic categories (negative, moderate, and positive). MPTX includes the combination of a mutation panel (ThyGeNEXT®) and a microRNA risk classifier (ThyraMIR®). A blinded, multicenter study was performed using consensus histopathology diagnosis among three pathologists to validate test performance. RESULTS Unanimous consensus diagnosis was reached in 197 subjects with indeterminate thyroid nodules; 36% had disease. MPTX had 95% sensitivity (95% CI,86%-99%) and 90% specificity (95% CI,84%-95%) for disease in prevalence adjusted nodules with Bethesda III and IV cytology. Negative MPTX results ruledout disease with 97% negative predictive value (NPV; 95% CI,91%-99%) at a 30% disease prevalence, while positive MPTX results ruledin high risk disease with 75% positive predictive value (PPV; 95% CI,60%-86%). Such results are expected in four out of five Bethesda III and IV nodules tested, including RAS positive nodules in which the microRNA classifier was useful in rulingin disease. 90% of mutation panel false positives were due to analytically verified RAS mutations detected in benign adenomas. Moderate MPTX results had a moderate rate of disease (39%, 95% CI,23%-54%), primarily due to RAS mutations, wherein the possibility of disease could not be excluded. CONCLUSIONS Our results emphasize that decisions for surgery should not solely be based on RAS or RAS-like mutations. MPTX informs management decisions while accounting for these challenges.
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Affiliation(s)
- Mark A. Lupo
- Thyroid & Endocrine Center of FloridaSarasotaFloridaUSA
| | - Ann E. Walts
- Cedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | | | | | - Peter M. Sadow
- Massachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Nicole Massoll
- University of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Ryan Campbell
- University of Arkansas for Medical SciencesLittle RockArkansasUSA
| | | | | | | | | | | | | | - Shikha Bose
- Cedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
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24
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Wang F, Wang C, Liu Y, Lan W, Wang R, Huang S, Cao C. NMR
Studies on the Interaction between Oncogene
RET
G‐Quadruplex
and Berberine
†. CHINESE J CHEM 2020. [DOI: 10.1002/cjoc.202000301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Fei Wang
- State Key Laboratory of Bioorganic and Natural Product Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences 345 Lingling Road Shanghai 200032 China
- University of Chinese Academy of Science No. 19A, Yuquan Road, Shijingshan District Beijing 100049 China
| | - Chunxi Wang
- State Key Laboratory of Bioorganic and Natural Product Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences 345 Lingling Road Shanghai 200032 China
- University of Chinese Academy of Science No. 19A, Yuquan Road, Shijingshan District Beijing 100049 China
| | - Yaping Liu
- State Key Laboratory of Bioorganic and Natural Product Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences 345 Lingling Road Shanghai 200032 China
- University of Chinese Academy of Science No. 19A, Yuquan Road, Shijingshan District Beijing 100049 China
| | - Wenxian Lan
- State Key Laboratory of Bioorganic and Natural Product Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences 345 Lingling Road Shanghai 200032 China
- University of Chinese Academy of Science No. 19A, Yuquan Road, Shijingshan District Beijing 100049 China
| | - Renxiao Wang
- State Key Laboratory of Bioorganic and Natural Product Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences 345 Lingling Road Shanghai 200032 China
- University of Chinese Academy of Science No. 19A, Yuquan Road, Shijingshan District Beijing 100049 China
| | - Shaohua Huang
- Institute of Drug Discovery Technology, Ningbo University No 818 Fenghua Road, Ningbo Zhejiang 315211 China
| | - Chunyang Cao
- State Key Laboratory of Bioorganic and Natural Product Chemistry, Center for Excellence in Molecular Synthesis, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences 345 Lingling Road Shanghai 200032 China
- University of Chinese Academy of Science No. 19A, Yuquan Road, Shijingshan District Beijing 100049 China
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Al-Jundi M, Thakur S, Gubbi S, Klubo-Gwiezdzinska J. Novel Targeted Therapies for Metastatic Thyroid Cancer-A Comprehensive Review. Cancers (Basel) 2020; 12:E2104. [PMID: 32751138 PMCID: PMC7463725 DOI: 10.3390/cancers12082104] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 07/22/2020] [Accepted: 07/25/2020] [Indexed: 12/18/2022] Open
Abstract
The knowledge on thyroid cancer biology has grown over the past decade. Thus, diagnostic and therapeutic strategies to manage thyroid cancer are rapidly evolving. With new insights into tumor biology and cancer genetics, several novel therapies have been approved for the treatment of thyroid cancer. Tyrosine kinase inhibitors (TKIs), such as lenvatinib and sorafenib, have been successfully utilized for the treatment of radioactive iodine (RAI)-refractory metastatic differentiated thyroid cancer (DTC). In addition, pretreatment with mitogen-activated protein kinase (MAPK) inhibitors (trametinib and selumetinib) has been shown to restore RAI avidity in previously RAI-refractory DTCs. Local therapies, such as external beam radiation and radiofrequency/ethanol ablation, have also been employed for treatment of DTC. Vandetanib and cabozantinib are the two TKIs currently approved by the Food and Drug Administration (FDA) for the treatment of medullary thyroid cancer (MTC). Other novel therapies, such as peptide receptor radionuclide therapy and carcinoembryonic antigen (CEA) vaccine, have also been utilized in treating MTC. Ongoing trials on selective rearranged-during-transfection (RET) protooncogene inhibitors, such as LOXO-292 and BLU-667, have demonstrated promising results in the treatment of metastatic MTC resistant to non-selective TKIs. The FDA-approved BRAF/MEK inhibitor combination of dabrafenib and trametinib has revolutionized treatment of BRAFV600E mutation positive anaplastic thyroid cancer. Several other emerging classes of medications, such as gene fusion inhibitors and immune checkpoint inhibitors, are being actively investigated in several clinical trials. In this review, we describe the molecular landscape of thyroid cancer and novel targeted therapies and treatment combinations available for the treatment of metastatic thyroid cancer.
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Affiliation(s)
| | | | | | - Joanna Klubo-Gwiezdzinska
- Thyroid Tumors and Functional Thyroid Disorders Section, Metabolic Disease Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20814, USA; (M.A.-J.); (S.T.); (S.G.)
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Zhang T, Liu Y, Ren X, Wang Z, Wang H. Glypican 2 regulates cell proliferation and metastasis in thyroid cancer cells. Mol Cell Toxicol 2020. [DOI: 10.1007/s13273-020-00073-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sistrunk JW, Shifrin A, Frager M, Bardales RH, Thomas J, Fishman N, Goldberg P, Guttler R, Grant E. Clinical performance of multiplatform mutation panel and microRNA risk classifier in indeterminate thyroid nodules. J Am Soc Cytopathol 2020; 9:232-241. [PMID: 32247769 DOI: 10.1016/j.jasc.2020.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/11/2020] [Accepted: 02/18/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION We evaluated the clinical performance of an expanded mutation panel in combination with microRNA classification (MPTX) for the management of indeterminate thyroid nodules. MATERIALS AND METHODS MPTX included testing of fine-needle aspirates from multiple centers with a combination of ThyGeNEXT mutation panel for strong and weak driver oncogenic changes and ThyraMIR microRNA risk classifier (both from Interpace Diagnostics; Pittsburgh, PA). MPTX test status (positive or negative) and MPTX clinical risk classifications (low, moderate, or high risk) were determined blind to patient outcomes. Surgical pathology and clinical follow-up records of patients from multiple centers were used to determine patient outcomes. MPTX performance was assessed by Kaplan Meier analysis for cancer-free survival of patients, with risk of malignancy determined by hazard ratio (HR). RESULTS Our study included 140 patients with AUS/FLUS or FN/SFN nodules, of which 13% had malignancy. MPTX negative test status and MPTX low risk results conferred a high probability (94%) that patients would remain cancer-free. MPTX positive test status (HR 11.2, P < 0.001) and MPTX moderate-risk results (HR 8.5, P = 0.001) were significant risk factors for malignancy, each conferring a 53% probability of malignancy. MPTX high-risk results elevated risk of malignancy even more so, conferring a 70% probability of malignancy (HR 38.5, P < 0.001). CONCLUSIONS MPTX test status accurately stratifies patients for risk of malignancy. Further classification using MPTX clinical risk categories enhances utility by accurately identifying patients at low, moderate, or high risk of malignancy at the low rate of malignancy encountered when clinically managing patients with indeterminate thyroid nodules.
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Affiliation(s)
| | - Alexander Shifrin
- Department of Surgery, Hackensack Meridian Health Jersey Shore University Medical Center, Neptune, New Jersey
| | - Marc Frager
- East Coast Medical Associates, Boca Raton, Florida
| | - Ricardo H Bardales
- Precision Pathology/Outpatient Pathology Associates, Sacramento, California
| | | | - Norman Fishman
- Diabetes & Endocrinology Specialists, Chesterfield, Missouri
| | | | | | - Edward Grant
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California
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Neck Mass that Moves with Swallowing. Surgery 2020. [DOI: 10.1007/978-3-030-05387-1_14] [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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Del Rivero J, Donahue RN, Marté JL, Gramza AW, Bilusic M, Rauckhorst M, Cordes L, Merino MJ, Dahut WL, Schlom J, Gulley JL, Madan RA. A Case Report of Sequential Use of a Yeast-CEA Therapeutic Cancer Vaccine and Anti-PD-L1 Inhibitor in Metastatic Medullary Thyroid Cancer. Front Endocrinol (Lausanne) 2020; 11:490. [PMID: 32849281 PMCID: PMC7427000 DOI: 10.3389/fendo.2020.00490] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/22/2020] [Indexed: 12/27/2022] Open
Abstract
Medullary thyroid cancer (MTC) accounts for ~4% of all thyroid malignancies. MTC derives from the neural crest and secretes calcitonin (CTN) and carcinoembryonic antigen (CEA). Unlike differentiated thyroid cancer, MTC does not uptake iodine and I-131 RAI (radioactive iodine) treatment is ineffective. Patients with metastatic disease are candidates for FDA-approved agents with either vandetanib or cabozantinib; however, adverse effects limit their use. There are ongoing trials exploring the role of less toxic immunotherapies in patients with MTC. We present a 61-year-old male with the diagnosis of MTC and persistent local recurrence despite multiple surgeries. He was started on sunitinib, but ultimately its use was limited by toxicity. He then presented to the National Cancer Institute (NCI) and was enrolled on a clinical trial with heat-killed yeast-CEA vaccine (NCT01856920) and his calcitonin doubling time improved in 3 months. He then came off vaccine for elective surgery. After surgery, his calcitonin was rising and he enrolled on a phase I trial of avelumab, a programmed death-ligand 1 (PD-L1) inhibitor (NCT01772004). Thereafter, his calcitonin decreased > 40% on 5 consecutive evaluations. His tumor was subsequently found to express PD-L1. CEA-specific T cells were increased following vaccination, and a number of potential immune-enhancing changes were noted in the peripheral immunome over the course of sequential immunotherapy treatment. Although calcitonin declines do not always directly correlate with clinical responses, this response is noteworthy and highlights the potential for immunotherapy or sequential immunotherapy in metastatic or unresectable MTC.
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Affiliation(s)
- Jaydira Del Rivero
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States
| | - Renee N Donahue
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States
| | - Jennifer L Marté
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States
| | - Ann W Gramza
- Medstar Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, United States
| | - Marijo Bilusic
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States
| | - Myrna Rauckhorst
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States
| | - Lisa Cordes
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States
| | - Maria J Merino
- Laboratory of Pathology, National Cancer Institute, Bethesda, MD, United States
| | - William L Dahut
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States
| | - Jeffrey Schlom
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States
| | - James L Gulley
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States
| | - Ravi A Madan
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, United States
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Kim J, Gosnell JE, Roman SA. Geographic influences in the global rise of thyroid cancer. Nat Rev Endocrinol 2020; 16:17-29. [PMID: 31616074 DOI: 10.1038/s41574-019-0263-x] [Citation(s) in RCA: 236] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2019] [Indexed: 12/11/2022]
Abstract
The incidence of thyroid cancer is on the rise, and this disease is projected to become the fourth leading type of cancer across the globe. From 1990 to 2013, the global age-standardized incidence rate of thyroid cancer increased by 20%. This global rise in incidence has been attributed to several factors, including increased detection of early tumours, the elevated prevalence of modifiable individual risk factors (for example, obesity) and increased exposure to environmental risk factors (for example, iodine levels). In this Review, we explore proven and novel hypotheses for how modifiable risk factors and environmental exposures might be driving the worldwide increase in the incidence of thyroid cancer. Although overscreening and the increased diagnosis of possibly clinically insignificant disease might have a role in certain parts of the world, other areas could be experiencing a true increase in incidence due to elevated exposure risks. In the current era of personalized medicine, national and international registry data should be applied to identify populations who are at increased risk for the development of thyroid cancer.
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Affiliation(s)
- Jina Kim
- University of California San Francisco, San Francisco, CA, USA
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Ciampi R, Romei C, Ramone T, Prete A, Tacito A, Cappagli V, Bottici V, Viola D, Torregrossa L, Ugolini C, Basolo F, Elisei R. Genetic Landscape of Somatic Mutations in a Large Cohort of Sporadic Medullary Thyroid Carcinomas Studied by Next-Generation Targeted Sequencing. iScience 2019; 20:324-336. [PMID: 31605946 PMCID: PMC6817656 DOI: 10.1016/j.isci.2019.09.030] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/01/2019] [Accepted: 09/23/2019] [Indexed: 02/04/2023] Open
Abstract
Sporadic Medullary Thyroid Carcinoma (sMTC) is a rare but aggressive thyroid tumor. RET and RAS genes are present in about 50%-80% of cases, but most of the remaining cases are still orphan of a genetic driver. We studied the largest series of sMTC by deep sequencing to define the mutational landscape. With this methodology we greatly reduced the number of RET- or RAS-negative cases and we confirmed the central role of RET and RAS mutations. Moreover, we highlighted the bad prognostic role of RET mutations in sMTC and consolidated the favorable prognostic role of RAS mutations. For the first time, we showed that the variant allele frequency represents an additional prognostic marker inside the group of RET-mutated sMTC.
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Affiliation(s)
- Raffaele Ciampi
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University-Hospital of Pisa, Pisa 56124 Italy.
| | - Cristina Romei
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University-Hospital of Pisa, Pisa 56124 Italy
| | - Teresa Ramone
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University-Hospital of Pisa, Pisa 56124 Italy
| | - Alessandro Prete
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University-Hospital of Pisa, Pisa 56124 Italy
| | - Alessia Tacito
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University-Hospital of Pisa, Pisa 56124 Italy
| | - Virginia Cappagli
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University-Hospital of Pisa, Pisa 56124 Italy
| | - Valeria Bottici
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University-Hospital of Pisa, Pisa 56124 Italy
| | - David Viola
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University-Hospital of Pisa, Pisa 56124 Italy
| | - Liborio Torregrossa
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University-Hospital of Pisa, Pisa 56124 Italy
| | - Clara Ugolini
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University-Hospital of Pisa, Pisa 56124 Italy
| | - Fulvio Basolo
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University-Hospital of Pisa, Pisa 56124 Italy
| | - Rossella Elisei
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University-Hospital of Pisa, Pisa 56124 Italy
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Shakiba E, Movahedi M, Majd A, Hedayati M. Investigating the expression and promoter methylation of RET gene in patients with medullary thyroid cancer with unmutated RET. J Cell Physiol 2019; 234:16304-16311. [PMID: 30873628 DOI: 10.1002/jcp.28295] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/02/2018] [Accepted: 12/07/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Thyroid cancer is one of the most common endocrine malignancies. Mutations in the rearranged during transfection (RET) gene, especially in exon 10, 11, and 16, as well as epigenetic modifications, constitute the major underlying molecular events leading to medullary thyroid cancer (MTC). There are few studies on the mutations and epigenetic changes of RET gene in Iranian patients with MTC. In the present study, we aimed to address this question and explore the clinical relevance of such genetic alternations in an Iranian population. METHODS Thirty-three patients with confirmed MTC who underwent thyroidectomy surgery in Imam Khomeini Hospital (Tehran, Iran) were enrolled. DNA extracted from cancerous tissues was amplified by polymerase chain reaction (PCR) and then was sequenced for identification of RET mutations. In patients with no identified mutations, the methylation status of RET promoter and its expression were further investigated using methylation-specific PCR and real-time PCR methods, respectively. RESULTS In MTC patients with no RET mutations, the promoter of the proto-oncogene was hypomethylated. Furthermore, RET gene expression was elevated in patients who revealed no mutations in neither of exon 10, 11, or 16 of the RET gene. CONCLUSION Hypomethylation of RET promoter may contribute to MTC pathogenesis. The methylation status of RET promoter could be a new potential prognostic, diagnostic and therapeutic marker in MTC.
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Affiliation(s)
- Elham Shakiba
- Department of Cellular and Molecular Biology, Faculty of Biological Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Monireh Movahedi
- Department of Cellular and Molecular Biology, Faculty of Biological Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Ahmad Majd
- Department of Cellular and Molecular Biology, Faculty of Biological Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Shabani N, Sheikholeslami S, Paryan M, Zarif Yeganeh M, Tavangar SM, Azizi F, Mohammadi-Yeganeh S, Hedayati M. An investigation on the expression of miRNAs including miR-144 and miR-34a in plasma samples of RET-positive and RET-negative medullar thyroid carcinoma patients. J Cell Physiol 2019; 235:1366-1373. [PMID: 31297834 DOI: 10.1002/jcp.29055] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 05/29/2019] [Indexed: 12/13/2022]
Abstract
Medullary thyroid carcinoma (MTC) is a scarce cancerous disease, originating from parafollicular C cells of the thyroid gland. MTC can be manifested as an aggressive carcinoma with metastasis, especially in sporadic forms. Mutations of the rearranged during transfection (RET) proto-oncogene occurs in all hereditary and a few somatic MTCs, so detection of RET mutations is needed for prompt and appropriate treatment. MicroRNAs (miRNAs) are noncoding regulatory RNAs. Extensive studies have done in progress or suppression of several types of cancers such as MTCs with the remarkable application as prognostic markers. Of the effective miRNAs in cancers, miR-144 and miR-34 were evaluated in our study. Blood samples of 25 RET-positive and 25 RET-negative blood samples of patients with MTC were evaluated for these miRNAs, using quantitative real-time polymerase chain reaction (RT-qPCR). Analysis of the results was performed by the 2 -ΔΔCt method, showing that miR-144 and miR-34a expression had a relative increase in patients with MTC compared with normal control samples and also in RET positives versus RET negatives. We recruited 50 out of 350 MTC plasma samples (27 female and 23 male) which were selected based on RET mutation in exon 11 (25 RET-positive and 25 RET-negative), with a mean ± SD age of 37.04 ± 1.74 years. Receiver operating characteristic (ROC) curve analysis was done to investigate the prognostic value of these miRNAs; although, they showed no significant prognostic value as MTC biomarkers in plasma samples. In conclusion, miRNAs can be used as biomarkers of cancers such as MTC; however, more studies are needed to find the best candidate miRNAs for the diagnosis of cancers.
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Affiliation(s)
- Noushin Shabani
- Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Sheikholeslami
- Cellular and Molecular Endocrine Research Center (CMERC), Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Paryan
- Department of Research and Development, Production and Research Complex, Pasteur Institute of Iran, Tehran, Iran
| | - Marjan Zarif Yeganeh
- Cellular and Molecular Endocrine Research Center (CMERC), Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Tavangar
- Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samira Mohammadi-Yeganeh
- Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center (CMERC), Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Febrero B, Rodríguez JM, Ríos A, Segura P, Pérez-Sánchez B, Torregrosa N, Hernández AM, Parrilla P. Prophylactic thyroidectomy in multiple endocrine neoplasia 2 (MEN2) patients with the C634Y mutation: A long-term follow-up in a large single-center cohort. Eur J Surg Oncol 2019; 45:625-630. [DOI: 10.1016/j.ejso.2018.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 07/12/2018] [Accepted: 09/04/2018] [Indexed: 02/05/2023] Open
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Del Rivero J, Edgerly M, Ward J, Madan RA, Balasubramaniam S, Fojo T, Gramza AW. Phase I/II Trial of Vandetanib and Bortezomib in Adults with Locally Advanced or Metastatic Medullary Thyroid Cancer. Oncologist 2018; 24:16-e14. [PMID: 30297385 PMCID: PMC6324636 DOI: 10.1634/theoncologist.2018-0452] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 07/24/2018] [Indexed: 02/07/2023] Open
Abstract
Lessons Learned. Vandetanib at a dose of 300 mg orally every day plus bortezomib 1.3 mg/m2 intravenously on days 1, 4, 8, and 11 could be administered safely. Assessing outcomes in 17 patients with medullary thyroid cancer, investigators considered the combination to be more difficult to administer than single‐agent vandetanib and that achieving better outcomes was unlikely. Consequently, a planned phase II study was terminated early.
Background. The proto‐oncogene RET (REarranged during Transfection) has a critical role in the pathogenesis of medullary thyroid cancer (MTC). Vandetanib (V), a multitargeted tyrosine kinase inhibitor approved for the treatment of MTC, is thought to inhibit RET in MTC. Supported by preclinical studies demonstrating that bortezomib (B) administration lowered RET mRNA and protein levels, we conducted a phase I study in advanced solid tumors of vandetanib in combination with bortezomib. The goal was to establish an RP2D (recommended phase II dose) for the combination of vandetanib plus bortezomib, a regimen envisioned as a dual strategy for targeting RET in MTC. Methods. Patients with advanced solid tumors were treated with escalating doses of bortezomib or vandetanib to assess the safety and tolerability of daily oral vandetanib and intravenous (IV) bortezomib administered on days 1, 4, 8, and 11 of a 28‐day cycle. Intrapatient dose escalation was allowed. Results. Twenty‐two patients were enrolled and received escalating mg/m2 bortezomib and mg vandetanib (number of patients) at initial doses of 1 and 100 (3), 1.3 and 100 (6), 1.3 and 200 (6), and 1.3 and 300 (7), respectively. Patients received a median of four cycles of bortezomib/vandetanib (range: 1–10), with 13 patients escalating to 1.3/200 and 10 to 1.3/300. G3 toxicities occurring in more than one patient included hypertension (24%), fatigue (19%), thrombocytopenia (10%), diarrhea (10%), and arthralgia (10%). There were no drug‐related G4/5 toxicities. There was one dose‐limiting toxicity, G3 thrombocytopenia, at bortezomib/vandetanib doses of 1.3/200 in cycle 2 that resolved without intervention. Four patients with a diagnosis of MTC (27%) had a partial response (PR). Conclusion. The MTD of the combination was established as bortezomib, 1.3 mg/m2 IV days 1, 4, 8, and 11 with vandetanib 300 mg p.o. daily. RECIST responses were observed in patients with a diagnosis of MTC.
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Affiliation(s)
- Jaydira Del Rivero
- Medical Oncology Service/Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Maureen Edgerly
- Medical Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jean Ward
- Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Ravi A Madan
- Genitourinary Malignancies, Branch Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | | | - Tito Fojo
- Department of Medicine, Division of Hematology Oncology, Columbia University Medical Center, New York New York, USA
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Ann W Gramza
- Medstar Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
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Maqdasy S, Costes-Chalret N, Batisse-Lignier M, Baron S, Tauveron I. Prostate adenocarcinoma in a young patient with multiple endocrine neoplasia 2B. ANNALES D'ENDOCRINOLOGIE 2018. [PMID: 29530270 DOI: 10.1016/j.ando.2017.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Salwan Maqdasy
- Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand, France; UMR CNRS 6293, Inserm U1103, département génétique reproduction et développement, université Clermont-Auvergne, BP 10448, 63177 Aubiere, France.
| | | | - Marie Batisse-Lignier
- Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand, France; UMR CNRS 6293, Inserm U1103, département génétique reproduction et développement, université Clermont-Auvergne, BP 10448, 63177 Aubiere, France
| | - Silvère Baron
- UMR CNRS 6293, Inserm U1103, département génétique reproduction et développement, université Clermont-Auvergne, BP 10448, 63177 Aubiere, France
| | - Igor Tauveron
- Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand, France; UMR CNRS 6293, Inserm U1103, département génétique reproduction et développement, université Clermont-Auvergne, BP 10448, 63177 Aubiere, France
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Lindquist D, Alsina FC, Herdenberg C, Larsson C, Höppener J, Wang N, Paratcha G, Tarján M, Tot T, Henriksson R, Hedman H. LRIG1 negatively regulates RET mutants and is downregulated in thyroid cancer. Int J Oncol 2018; 52:1189-1197. [PMID: 29436694 PMCID: PMC5843404 DOI: 10.3892/ijo.2018.4273] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 01/24/2018] [Indexed: 12/18/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma (MTC) are characterized by genomic rearrangements and point mutations in the proto-oncogene RET. Leucine-rich repeats and immunoglobulin-like domains 1 (LRIG1) is a suppressor of various receptor tyrosine kinases, including RET. LRIG1 expression levels are associated with patient survival in many cancer types. In the present study, we investigated whether the oncogenic RET mutants RET2A (C634R) and RET2B (M918T) were regulated by LRIG1, and the possible effects of LRIG1 expression in thyroid cancer were investigated in three different clinical cohorts and in a RET2B-driven mouse model of MTC. LRIG1 was shown to physically interact with both RET2A and RET2B and to restrict their ligand-independent activation. LRIG1 mRNA levels were downregulated in PTC and MTC compared to normal thyroid gland tissue. There was no apparent association between LRIG1 RNA or protein expression levels and patient survival in the studied cohorts. The transgenic RET2B mice developed pre-cancerous medullary thyroid lesions at a high frequency (36%); however, no overt cancers were observed. There was no significant difference in the incidence of pre-cancerous lesions between Lrig1 wild-type and Lrig1-deficient RET2B mice. In conclusion, the findings that LRIG1 is a negative regulator of RET2A and RET2B and is also downregulated in PTC and MTC may suggest that LRIG1 functions as a thyroid tumor suppressor.
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Affiliation(s)
- David Lindquist
- Oncology Research Laboratory, Department of Radiation Sciences, Umeå University, SE-90187 Umeå, Sweden
| | - Fernando C Alsina
- Institute of Cell Biology and Neuroscience (IBCN)-CONICET, School of Medicine, University of Buenos Aires (UBA), Buenos Aires 1121, Argentina
| | - Carl Herdenberg
- Oncology Research Laboratory, Department of Radiation Sciences, Umeå University, SE-90187 Umeå, Sweden
| | - Catharina Larsson
- Department of Oncology-Pathology, Karolinska Institutet, Cancer Center Karolinska, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Jo Höppener
- University Medical Center Utrecht, Division of Biomedical Genetics and Laboratory of Translational Immunology, 3508 GA Utrecht, The Netherlands
| | - Na Wang
- Department of Oncology-Pathology, Karolinska Institutet, Cancer Center Karolinska, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Gustavo Paratcha
- Institute of Cell Biology and Neuroscience (IBCN)-CONICET, School of Medicine, University of Buenos Aires (UBA), Buenos Aires 1121, Argentina
| | - Miklós Tarján
- Department of Pathology and Clinical Cytology, Central Hospital Falun, 791 82 Falun, Sweden
| | - Tibor Tot
- Department of Pathology and Clinical Cytology, Central Hospital Falun, 791 82 Falun, Sweden
| | - Roger Henriksson
- Oncology Research Laboratory, Department of Radiation Sciences, Umeå University, SE-90187 Umeå, Sweden
| | - Håkan Hedman
- Oncology Research Laboratory, Department of Radiation Sciences, Umeå University, SE-90187 Umeå, Sweden
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Schlumberger M, Elisei R, Müller S, Schöffski P, Brose M, Shah M, Licitra L, Krajewska J, Kreissl MC, Niederle B, Cohen EEW, Wirth L, Ali H, Clary DO, Yaron Y, Mangeshkar M, Ball D, Nelkin B, Sherman S. Overall survival analysis of EXAM, a phase III trial of cabozantinib in patients with radiographically progressive medullary thyroid carcinoma. Ann Oncol 2017; 28:2813-2819. [PMID: 29045520 PMCID: PMC5834040 DOI: 10.1093/annonc/mdx479] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Primary analysis of the double-blind, phase III Efficacy of XL184 (Cabozantinib) in Advanced Medullary Thyroid Cancer (EXAM) trial demonstrated significant improvement in progression-free survival with cabozantinib versus placebo in patients with progressive medullary thyroid cancer (MTC). Final analysis of overall survival (OS), a key secondary endpoint, was carried out after long-term follow-up. PATIENTS AND METHODS EXAM compared cabozantinib with placebo in 330 patients with documented radiographic progression of metastatic MTC. Patients were randomized (2:1) to cabozantinib (140 mg/day) or placebo. Final OS and updated safety data are reported. RESULTS Minimum follow-up was 42 months. Kaplan-Meier analysis showed a 5.5-month increase in median OS with cabozantinib versus placebo (26.6 versus 21.1 months) although the difference did not reach statistical significance [stratified hazard ratio (HR), 0.85; 95% confidence interval (CI), 0.64-1.12; P = 0.24]. In an exploratory assessment of OS, progression-free survival, and objective response rate, cabozantinib appeared to have a larger treatment effect in patients with RET M918T mutation-positive tumors compared with patients not harboring this mutation. For patients with RET M918T-positive disease, median OS was 44.3 months for cabozantinib versus 18.9 months for placebo [HR, 0.60; 95% CI, 0.38-0.94; P = 0.03 (not adjusted for multiple subgroup analyses)], with corresponding values of 20.2 versus 21.5 months (HR, 1.12; 95% CI, 0.70-1.82; P = 0.63) in the RET M918T-negative subgroup. Median treatment duration was 10.8 months with cabozantinib and 3.4 months with placebo. The safety profile for cabozantinib remained consistent with that of the primary analysis. CONCLUSION The secondary end point was not met in this final OS analysis from the trial of cabozantinib in patients with metastatic, radiographically progressive MTC. A statistically nonsignificant increase in OS was observed for cabozantinib compared with placebo. Exploratory analyses suggest that patients with RET M918T-positive tumors may experience a greater treatment benefit with cabozantinib. TRIAL REGISTRATION NUMBER NCT00704730.
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Affiliation(s)
- M Schlumberger
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and University Paris-Saclay, Villejuif, France.
| | - R Elisei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Müller
- Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | - P Schöffski
- Department of General Medical Oncology, KU Leuven, Leuven; Laboratory of Experimental Oncology at the University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - M Brose
- Department of Otorhinolaryngology: Head and Neck Surgery, Abramson Cancer Center of the University of Pennsylvania, Philadelphia
| | - M Shah
- Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, USA
| | - L Licitra
- IRCCS Foundation, National Cancer Institute, Milan; University of Milan, Milan, Italy
| | - J Krajewska
- Maria Skłodowska-Curie Memorial Institute - Cancer Center Gliwice Branch, Gliwice, Poland
| | - M C Kreissl
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - B Niederle
- Division of Surgical Endocrinology, Medical University of Vienna, Vienna, Austria
| | - E E W Cohen
- University of California San Diego Moores Cancer Center, La Jolla
| | - L Wirth
- Department of Hematology/Oncology, Massachusetts General Hospital, Boston
| | - H Ali
- Henry Ford Health System, Detroit
| | | | - Y Yaron
- Exelixis, Inc, South San Francisco
| | | | - D Ball
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore
| | - B Nelkin
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore
| | - S Sherman
- Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, USA
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Lu F, Chen X, Bai Y, Feng Y, Wu J. A large Chinese pedigree of multiple endocrine neoplasia type 2A with a novel C634Y/D707E germline mutation in RET exon 11. Oncol Lett 2017; 14:3552-3558. [PMID: 28943896 PMCID: PMC5592869 DOI: 10.3892/ol.2017.6583] [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: 10/16/2015] [Accepted: 03/17/2017] [Indexed: 11/24/2022] Open
Abstract
The present study identified the clinical features of the largest multiple endocrine neoplasia type 2 (MEN2) A pedigree from China, with a novel double missense rearranged during transfection (RET) mutation (C634Y/D707E). To the best of our knowledge, the D707E mutation has not been identified to date. In the present study, a total of 101 family members who originated from a large pedigree (134 members in total) underwent RET mutation screening by next-generation sequencing and polymerase chain reaction (PCR) amplification, followed by direct bidirectional DNA sequencing. The clinical features of this pedigree were carefully reviewed retrospectively, and statistical analyses were conducted using SPSS software. A total of 33 (32.67%) carriers were identified to exhibit the C634Y/D707E RET germline mutation. The mean age of the patients with medullary thyroid carcinoma (MTC) identified by RET screening was 38.4±16.5 years (n=11; range, 14–65 years). Only 4 patients with pheochromocytoma with a median age of 37 years were identified. No hyperparathyroidism was diagnosed. Persistent or recurrent disease developed in the patients of the present study who underwent inappropriate initial thyroid surgeries that were performed in previous decades (III10, III23, III24, III27 and IV46, as they had undergone two surgeries prior to the present study). A total of 66.70% (6/9) of patients, following thyroidectomy, continued to develop persistent or recurrent disease during the present screening study. In total, 3 patients succumbed to MTC or distant metastasis in the present study. The increase in carcinoembryonic antigen (CEA) levels correlated with the increase in basal serum calcitonin (Ct) levels according to Pearson correlation analysis in patients with MTC without surgery. Ct and CEA levels were also significantly correlated with tumor volumes. To the best of our knowledge, the present study is the first to identify a novel double RET missense mutation in the largest MEN2A pedigree from China. Additional in-depth study is necessary to elucidate the molecular mechanisms of the D707E mutation and its potential joint effects with the other C634Y mutation in the pedigree of the present study.
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Affiliation(s)
- Fanqian Lu
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, P.R. China.,Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing 100005, P.R. China
| | - Xiaohong Chen
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, P.R. China.,Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing 100005, P.R. China
| | - Yunlong Bai
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, P.R. China.,Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing 100005, P.R. China
| | - Yaru Feng
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, P.R. China.,Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing 100005, P.R. China
| | - Jian Wu
- MyGenostics, Inc., Beijing 101318, P.R. China
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Yang J, Chen K, Zhang G, Yang QY, Li YS, Huang SZ, Wang YL, Yang W, Jiang XJ, Yan HX, Zhu JQ, Xiang R, Luo YF, Li WM, Wei YQ, Li LL, Yang SY. Structural optimization and structure-activity relationship studies of N-phenyl-7,8-dihydro-6H-pyrimido[5,4-b][1,4]oxazin-4-amine derivatives as a new class of inhibitors of RET and its drug resistance mutants. Eur J Med Chem 2017; 143:1148-1164. [PMID: 29133048 DOI: 10.1016/j.ejmech.2017.09.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 09/09/2017] [Accepted: 09/11/2017] [Indexed: 02/05/2023]
Abstract
The RET tyrosine kinase is an important therapeutic target for medullary thyroid cancer (MTC), and drug resistance mutations of RET, particularly V804M and V804L, are a main challenge for the current targeted therapy of MTC based on RET inhibitors. In this investigation, we report the structural optimization and structure-activity relationship studies of N-phenyl-7,8-dihydro-6H-pyrimido[5,4-b][1,4]oxazin-4-amine derivatives as a new class of RET inhibitors. Among all the obtained kinase inhibitors, 1-(5-(tert-butyl)isoxazol-3-yl)-3-(4-((6,7,8,9-tetrahydropyrimido[5,4-b][1,4]oxazepin-4-yl)amino)phenyl)urea (17d) is a multi-kinase inhibitor and potently inhibits RET and its drug resistance mutants. It showed IC50 (half maximal inhibitory concentration) values of 0.010 μM, 0.015 μM, and 0.009 μM against RET-wild-type, RET-V804M, and RET-V804L, respectively. 17d displayed significant anti-viability potencies against various RET-driving tumor cell lines. In a xenograft mouse model of NIH3T3-RET-C634Y, 17d exhibited potent in vivo anti-tumor activity, and no obvious toxicity was observed. Mechanisms of action were also investigated by Western blot and immunohistochemical assays. Collectively, 17d could be a promising agent for the treatment of MTC, hence deserving a further investigation.
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Affiliation(s)
- Jiao Yang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Kai Chen
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Guo Zhang
- Key Laboratory of Drug Targeting and Drug Delivery System of Ministry of Education, West China School of Pharmacy, Sichuan University, Sichuan 610041, China
| | - Qiu-Yuan Yang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Yue-Shan Li
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Shen-Zhen Huang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Yan-Lin Wang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Wei Yang
- Key Laboratory of Drug Targeting and Drug Delivery System of Ministry of Education, West China School of Pharmacy, Sichuan University, Sichuan 610041, China
| | - Xiao-Juan Jiang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Heng-Xiu Yan
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Jing-Qiang Zhu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Rong Xiang
- Department of Clinical Medicine, School of Medicine, Nankai University, Tianjin 300071, China
| | - You-Fu Luo
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Wei-Min Li
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Yu-Quan Wei
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China
| | - Lin-Li Li
- Key Laboratory of Drug Targeting and Drug Delivery System of Ministry of Education, West China School of Pharmacy, Sichuan University, Sichuan 610041, China.
| | - Sheng-Yong Yang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University/Collaborative Innovation Center of Biotherapy, Chengdu, Sichuan 610041, China.
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Targeting miRNAs by polyphenols: Novel therapeutic strategy for cancer. Semin Cancer Biol 2017; 46:146-157. [PMID: 28185862 DOI: 10.1016/j.semcancer.2017.02.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/01/2017] [Accepted: 02/03/2017] [Indexed: 12/18/2022]
Abstract
In the recent years, polyphenols have gained significant attention in scientific community owing to their potential anticancer effects against a wide range of human malignancies. Epidemiological, clinical and preclinical studies have supported that daily intake of polyphenol-rich dietary fruits have a strong co-relationship in the prevention of different types of cancer. In addition to direct antioxidant mechanisms, they also regulate several therapeutically important oncogenic signaling and transcription factors. However, after the discovery of microRNA (miRNA), numerous studies have identified that polyphenols, including epigallocatechin-3-gallate, genistein, resveratrol and curcumin exert their anticancer effects by regulating different miRNAs which are implicated in all the stages of cancer. MiRNAs are short, non-coding endogenous RNA, which silence the gene functions by targeting messenger RNA (mRNA) through degradation or translation repression. However, cancer associated miRNAs has emerged only in recent years to support its applications in cancer therapy. Preclinical experiments have suggested that deregulation of single miRNA is sufficient for neoplastic transformation of cells. Indeed, the widespread deregulation of several miRNA profiles of tumor and healthy tissue samples revealed the involvement of many types of miRNA in the development of numerous cancers. Hence, targeting the miRNAs using polyphenols will be a novel and promising strategy in anticancer chemotherapy. Herein, we have critically reviewed the potential applications of polyphenols on various human miRNAs, especially which are involved in oncogenic and tumor suppressor pathways.
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Abstract
We report a case of axillary lymph node metastasis as a consequence of medullary thyroid carcinoma (MTC) in a 42-year-old man. On January 2009, the patient was referred to us for the management of right cervical lymph node enlargement. Total thyroidectomy was performed with right-sided functional neck dissection. Postoperative histopathology revealed MTC in the right lobe of the thyroid, with extrathyroidal extension and right-sided neck metastases. Multiple left cervical, mediastinal, and right axillary lymphadenopathies were detected at the third year follow-up exam. Left-sided functional neck dissection, axillary lymph node dissection, and mediastinal lymph node dissection were performed, and the pathologic outcomes revealed as the metastatic dissemination of MTC. After a disease-free term for 1 year, multiple metastatic lesions were detected in the patient.
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Lassalle S, Zangari J, Popa A, Ilie M, Hofman V, Long E, Patey M, Tissier F, Belléannée G, Trouette H, Catargi B, Peyrottes I, Sadoul JL, Bordone O, Bonnetaud C, Butori C, Bozec A, Guevara N, Santini J, Hénaoui IS, Lemaire G, Blanck O, Vielh P, Barbry P, Mari B, Brest P, Hofman P. MicroRNA-375/SEC23A as biomarkers of the in vitro efficacy of vandetanib. Oncotarget 2016; 7:30461-78. [PMID: 27036030 PMCID: PMC5058693 DOI: 10.18632/oncotarget.8458] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/10/2016] [Indexed: 01/28/2023] Open
Abstract
In this study, we performed microRNA (miRNA) expression profiling on a large series of sporadic and hereditary forms of medullary thyroid carcinomas (MTC). More than 60 miRNAs were significantly deregulated in tumor vs adjacent non-tumor tissues, partially overlapping with results of previous studies. We focused our attention on the strongest up-regulated miRNA in MTC samples, miR-375, the deregulation of which has been previously observed in a variety of human malignancies including MTC. We identified miR-375 targets by combining gene expression signatures from human MTC (TT) and normal follicular (Nthy-ori 3-1) cell lines transfected with an antagomiR-375 inhibitor or a miR-375 mimic, respectively, and from an in silico analysis of thyroid cell lines of Cancer Cell Line Encyclopedia datasets. This approach identified SEC23A as a bona fide miR-375 target, which we validated by immunoblotting and immunohistochemistry of non-tumor and pathological thyroid tissue. Furthermore, we observed that miR-375 overexpression was associated with decreased cell proliferation and synergistically increased sensitivity to vandetanib, the clinically relevant treatment of metastatic MTC. We found that miR-375 increased PARP cleavage and decreased AKT phosphorylation, affecting both cell proliferation and viability. We confirmed these results through SEC23A direct silencing in combination with vandetanib, highlighting the importance of SEC23A in the miR-375-associated increased sensitivity to vandetanib.Since the combination of increased expression of miR-375 and decreased expression of SEC23A point to sensitivity to vandetanib, we question if the expression levels of miR-375 and SEC23A should be evaluated as an indicator of eligibility for treatment of MTC patients with vandetanib.
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Affiliation(s)
- Sandra Lassalle
- Centre Hospitalier Universitaire de Nice, Laboratory of Clinical and Experimental Pathology, Nice, France
- Institute of Research on Cancer and Ageing of Nice (IRCAN), INSERM U1081/CNRS UMR7284, Nice, France
- University of Nice Sophia-Antipolis, Nice, France
- Centre Hospitalier Universitaire de Nice, Hospital Integrated Biobank (BB 0033-00025), Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
| | - Joséphine Zangari
- Institute of Research on Cancer and Ageing of Nice (IRCAN), INSERM U1081/CNRS UMR7284, Nice, France
- University of Nice Sophia-Antipolis, Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
| | - Alexandra Popa
- University of Nice Sophia-Antipolis, Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
- Institut de Pharmacologie Moléculaire et Cellulaire IPMC, CNRS UMR7275, Sophia-Antipolis, France
| | - Marius Ilie
- Centre Hospitalier Universitaire de Nice, Laboratory of Clinical and Experimental Pathology, Nice, France
- Institute of Research on Cancer and Ageing of Nice (IRCAN), INSERM U1081/CNRS UMR7284, Nice, France
- University of Nice Sophia-Antipolis, Nice, France
- Centre Hospitalier Universitaire de Nice, Hospital Integrated Biobank (BB 0033-00025), Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
| | - Véronique Hofman
- Centre Hospitalier Universitaire de Nice, Laboratory of Clinical and Experimental Pathology, Nice, France
- Institute of Research on Cancer and Ageing of Nice (IRCAN), INSERM U1081/CNRS UMR7284, Nice, France
- University of Nice Sophia-Antipolis, Nice, France
- Centre Hospitalier Universitaire de Nice, Hospital Integrated Biobank (BB 0033-00025), Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
| | - Elodie Long
- Centre Hospitalier Universitaire de Nice, Laboratory of Clinical and Experimental Pathology, Nice, France
- Institute of Research on Cancer and Ageing of Nice (IRCAN), INSERM U1081/CNRS UMR7284, Nice, France
- University of Nice Sophia-Antipolis, Nice, France
- Centre Hospitalier Universitaire de Nice, Hospital Integrated Biobank (BB 0033-00025), Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
| | - Martine Patey
- Hôpital Universitaire de Reims - Hôpital Robert Debré, Department of Pathology, Institut Jean Godinot, Reims, France
| | - Frédérique Tissier
- Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Laboratory of Pathology, Paris, France
| | - Geneviève Belléannée
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Universitaire de Pessac-Haut Lévêque, Laboratory of Pathology, Pessac, France
| | - Hélène Trouette
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Universitaire de Pessac-Haut Lévêque, Laboratory of Pathology, Pessac, France
| | - Bogdan Catargi
- Centre Hospitalier Universitaire de Bordeaux, Department of Endocrinology, Pessac, France
| | - Isabelle Peyrottes
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
- Centre Antoine Lacassagne, Laboratory of Pathology, Nice, France
| | - Jean-Louis Sadoul
- Centre Hospitalier Universitaire de Nice, Hôpital de l'Archet, Department of Endocrinology, Nice, France
| | - Olivier Bordone
- Centre Hospitalier Universitaire de Nice, Hospital Integrated Biobank (BB 0033-00025), Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
| | - Christelle Bonnetaud
- Centre Hospitalier Universitaire de Nice, Hospital Integrated Biobank (BB 0033-00025), Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
| | - Catherine Butori
- Centre Hospitalier Universitaire de Nice, Laboratory of Clinical and Experimental Pathology, Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
| | - Alexandre Bozec
- Institute of Research on Cancer and Ageing of Nice (IRCAN), INSERM U1081/CNRS UMR7284, Nice, France
- University of Nice Sophia-Antipolis, Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
- Centre Antoine Lacassagne, Head and Neck Institute, Surgery and Otorhinolaryngology Department, Nice, France
| | - Nicolas Guevara
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
- Centre Antoine Lacassagne, Head and Neck Institute, Surgery and Otorhinolaryngology Department, Nice, France
| | - José Santini
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
- Centre Antoine Lacassagne, Head and Neck Institute, Surgery and Otorhinolaryngology Department, Nice, France
| | - Imène Sarah Hénaoui
- University of Nice Sophia-Antipolis, Nice, France
- Institut de Pharmacologie Moléculaire et Cellulaire IPMC, CNRS UMR7275, Sophia-Antipolis, France
| | - Géraldine Lemaire
- Bayer CropScience SA, Research Center, Sophia Antipolis, Valbonne, France
| | - Olivier Blanck
- Bayer CropScience SA, Research Center, Sophia Antipolis, Valbonne, France
| | - Philippe Vielh
- Institut Gustave Roussy, Translational Research Laboratory, Department of Pathology, Villejuif, France
| | - Pascal Barbry
- University of Nice Sophia-Antipolis, Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
- Institut de Pharmacologie Moléculaire et Cellulaire IPMC, CNRS UMR7275, Sophia-Antipolis, France
| | - Bernard Mari
- University of Nice Sophia-Antipolis, Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
- Institut de Pharmacologie Moléculaire et Cellulaire IPMC, CNRS UMR7275, Sophia-Antipolis, France
| | - Patrick Brest
- Institute of Research on Cancer and Ageing of Nice (IRCAN), INSERM U1081/CNRS UMR7284, Nice, France
- University of Nice Sophia-Antipolis, Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
| | - Paul Hofman
- Centre Hospitalier Universitaire de Nice, Laboratory of Clinical and Experimental Pathology, Nice, France
- Institute of Research on Cancer and Ageing of Nice (IRCAN), INSERM U1081/CNRS UMR7284, Nice, France
- University of Nice Sophia-Antipolis, Nice, France
- Centre Hospitalier Universitaire de Nice, Hospital Integrated Biobank (BB 0033-00025), Nice, France
- Fédération Hospitalo-Universitaire “OncoAge”, University of Nice Sophia Antipolis, Nice, France
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Heilmann AM, Subbiah V, Wang K, Sun JX, Elvin JA, Chmielecki J, Sherman SI, Murthy R, Busaidy NL, Subbiah I, Yelensky R, Nangia C, Vergilio JA, Khan SA, Erlich RL, Lipson D, Ross JS, Miller VA, Shah MH, Ali SM, Stephens PJ. Comprehensive Genomic Profiling of Clinically Advanced Medullary Thyroid Carcinoma. Oncology 2016; 90:339-46. [PMID: 27207748 DOI: 10.1159/000445978] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 04/05/2016] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The aim of this study was to determine the genomic alterations of cancer-related genes in advanced medullary thyroid carcinoma during the course of clinical care. METHODS Hybrid-capture-based comprehensive genomic profiling was performed on 34 consecutive medullary thyroid carcinoma cases to identify all four classes of genomic alterations, and outcome for an index patient was collected. RESULTS RET was mutated in 88% (30/34) of cases, with RET M918T being responsible for 70% (21/30) of the RET alterations. The other RET alterations were RET E632_L633del, C634R, C620R, C618G/R/S, V804M, and RET amplification. Two of the four RET wild-type patients harbored mutations in KRAS or HRAS (1/34 each). The next most frequent genomic alterations were amplifications of CCND1, FGF3, and FGF19 and alterations in CDKN2A (3/34 each). One case with a RET M918T mutation developed acquired resistance to progressively dose-escalated vandetanib. When the mTOR inhibitor everolimus was added to continued vandetanib treatment, the patient achieved a second 25% reduction of tumor volume (RECIST 1.1) for 8 months. CONCLUSIONS Comprehensive genomic profiling identified the full breadth of RET alterations in metastatic medullary thyroid carcinoma and possible cooperating oncogenic driver alterations. This approach may refine the use of targeted therapy for these patients.
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Cao J, Chen C, Chen C, Wang QL, Ge MH. Clinicopathological features and prognosis of familial papillary thyroid carcinoma--a large-scale, matched, case-control study. Clin Endocrinol (Oxf) 2016; 84:598-606. [PMID: 26191611 DOI: 10.1111/cen.12859] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 06/01/2015] [Accepted: 07/13/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE It remains controversial whether or not the aggressiveness of familial nonmedullary thyroid cancer (FNMTC) differs from sporadic carcinoma. The aim of this study was to determine the clinicopathological features and prognosis of FNMTC. DESIGN A matched-case comparative study. METHODS Three hundred and seventy-two patients with familial papillary thyroid carcinoma (FPTC) were enrolled as the study group, and another 372 patients with sporadic PTC were enrolled as controls and matched for gender, age, tumour/node/metastasis (TNM) staging and approximate duration of follow-up. We compared the differences in the clinicopathological features and prognosis between the subgroups. RESULTS Compared with sporadic PTC, patients with FPTC were more likely to present tumour multicentricity, bilateral growth and a concomitant nodular goitre (P < 0·05). In papillary thyroid microcarcinoma (PTMC), a higher recurrence rate was noted in patients with a family history of PTC, and this remained independently predictive on multivariate analysis. The patients with FPTC in the second generation showed an earlier age of onset, more frequent Hashimoto's thyroiditis and a higher recurrence rate than the first generation, while the first-generation offspring of patients had a higher incidence of nodular goitre than the second generation. CONCLUSIONS The presence of familial history in PTC indicates an increase in biological aggressiveness, and patients in the second generation may exhibit the 'genetic anticipation' phenomenon. At present, the available data are not sufficient to support a more aggressive approach for FPTC. However, a family history of PTC is an independent risk factor for recurrence in patients with PTMC.
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Affiliation(s)
- Jun Cao
- The Affiliated Tumor Hospital of Zhejiang Chinese Medical University, Hangzhou, China
- Department of Head and Neck Surgery, Zhejiang Province Cancer Hospital, Gongshu District, Hangzhou, China
| | - Can Chen
- The Affiliated Tumor Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Chao Chen
- Department of Head and Neck Surgery, Zhejiang Province Cancer Hospital, Gongshu District, Hangzhou, China
| | - Qing-Liang Wang
- Department of Head and Neck Surgery, Zhejiang Province Cancer Hospital, Gongshu District, Hangzhou, China
| | - Ming-Hua Ge
- Department of Head and Neck Surgery, Zhejiang Province Cancer Hospital, Gongshu District, Hangzhou, China
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Risk-reduction surgery in pediatric surgical oncology: A perspective. J Pediatr Surg 2016; 51:675-87. [PMID: 26898681 DOI: 10.1016/j.jpedsurg.2016.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 01/21/2016] [Accepted: 01/21/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE A small percentage of pediatric solid cancers arise as a result of clearly identified inherited predisposition syndromes and nongenetic lesions. Evidence supports preemptive surgery for children with genetic [multiple endocrine neoplasia type 2 (MEN2), familial adenomatous polyposis syndrome (FAP), hereditary nonpolyposis colorectal cancer (HNPCC), and hereditary diffuse gastric cancer (HDGC) and nongenetic [thyroglossal duct cysts (TGDC), congenital pulmonary airway malformations (CPAM), alimentary tract duplication cysts (ATDC), and congenital choledochal cysts (CCC)] developmental anomalies. Our aim was to explore the utility of risk reduction surgery to treat and prevent cancer in children. METHODS A systematic review of the available peer-reviewed literature on PubMed was performed using a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) search strategy, where possible. Search items included "risk reduction surgery", "hereditary cancer predisposition syndrome", "multiple endocrine neoplasia type 2", "familial adenomatous polyposis", "hereditary nonpolyposis colorectal cancer", "hereditary diffuse gastric cancer", "thyroglossal duct cysts", congenital pulmonary airway malformations", "alimentary tract duplication cysts", "malignant transformation", and "guidelines". RESULTS We identified 67 articles that met the inclusion criteria describing the indications for prophylactic surgery in surgical oncology. For the genetic predisposition syndromes, 7 studies were related to professional endorsed guidelines, 7 were related to surgery for MEN2, 11 were related to colectomy for FAP, 6 were related to colectomy for HNPCC, and 12 related to gastrectomy for HDGC. Articles for the nongenetic lesions included 5 for techniques related to TGDC resection, 9 for surgery for CPAMs, and 10 for resection of ATDCs. Guidelines and strategies varied significantly especially related to the extent and timing of surgical intervention; the exception was for the timing of thyroidectomy in children with MEN2. CONCLUSION Current evidence supporting prophylactic surgery in the management of pediatric cancer predisposition syndromes and nongenetic lesions is best delineated for thyroidectomy to prevent medullary thyroid cancer in children with MEN2 (Strength of Recommendation Grade B/C). Despite the lack of pediatric specific evidence-based recommendations regarding the appropriate extent and timing for risk-reduction surgery for FAP, HNPCC, HDGC and nongenetic anomalies, our review represents an opportunity towards understanding the postgenomic development of these lesions and provides current indications and techniques for preemptive cancer prevention surgery in children.
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Raue F, Frank-Raue K. Epidemiology and Clinical Presentation of Medullary Thyroid Carcinoma. Recent Results Cancer Res 2016; 204:61-90. [PMID: 26494384 DOI: 10.1007/978-3-319-22542-5_3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor originating from the thyroid C cells producing mainly calcitonin (CTN) used as tumor marker. MTC occurs either sporadic (75%) or in a hereditary form (multiple endocrine neoplasia type 2, MEN2), due to germline mutations in the RET proto-oncogene. The discovery of an MTC in a patient has several diagnostic implications involving a specific strategy: preoperative evaluation of the tumor marker CTN and the extent of the disease, classification of MTC as sporadic or hereditary by DNA testing, and screening for associated endocrinopathies in hereditary MTC. Elevated CTN is a highly sensitive and specific tumor marker for diagnosis and follow-up of MTC. CTN is directly related to the tumor mass. In patients with nodular thyroid disease, diagnosis of MTC could be made by CTN determination as an indicator of tumor burden in conjunction with fine-needle aspiration. Patients with confirmed sporadic or hereditary MTC should have a total thyroidectomy and depending on the preoperative CTN value and the extent of disease additional dissection of the lymph nodes in the central and lateral neck compartment. In MEN 2 patients diagnosed by screening, the time of prophylactic thyroidectomy depends on RET mutation and CTN level.
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Affiliation(s)
- Friedhelm Raue
- Endokrinologische Gemeinschaftspraxis, Brückenstr. 21, 69120, Heidelberg, Germany.
| | - Karin Frank-Raue
- Endokrinologische Gemeinschaftspraxis, Brückenstr. 21, 69120, Heidelberg, Germany
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Hedayati M, Zarif Yeganeh M, Sheikholeslami S, Afsari F. Diversity of mutations in the RET proto-oncogene and its oncogenic mechanism in medullary thyroid cancer. Crit Rev Clin Lab Sci 2016; 53:217-27. [PMID: 26678667 DOI: 10.3109/10408363.2015.1129529] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Thyroid cancer is the most common endocrine malignancy and accounts for nearly 1% of all of human cancer. Thyroid cancer has four main histological types: papillary, follicular, medullary, and anaplastic. Papillary, follicular, and anaplastic thyroid carcinomas are derived from follicular thyroid cells, whereas medullary thyroid carcinoma (MTC) originates from the neural crest parafollicular cells or C-cells of the thyroid gland. MTC represents a neuroendocrine tumor and differs considerably from differentiated thyroid carcinoma. MTC is one of the aggressive types of thyroid cancer, which represents 3-10% of all thyroid cancers. It occurs in hereditary (25%) and sporadic (75%) forms. The hereditary form of MTC has an autosomal dominant mode of inheritance. According to the present classification, hereditary MTC is classified as a multiple endocrine neoplasi type 2 A & B (MEN2A & MEN2B) and familial MTC (FMTC). The RET proto-oncogene is located on chromosome 10q11.21. It is composed of 21 exons and encodes a transmembrane receptor tyrosine kinase. RET regulates a complex network of signal transduction pathways during development, survival, proliferation, differentiation, and migration of the enteric nervous system progenitor cells. Gain of function mutations in RET have been well demonstrated in MTC development. Variants of MTC result from different RET mutations, and they have a good genotype-phenotype correlation. Various MTC related mutations have been reported in different exons of the RET gene. We proposed that RET genetic mutations may be different in distinct populations. Therefore, the aim of this study was to find a geographical pattern of RET mutations in different populations.
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Affiliation(s)
- Mehdi Hedayati
- a Cellular and Molecular Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Marjan Zarif Yeganeh
- a Cellular and Molecular Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Sara Sheikholeslami
- a Cellular and Molecular Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Farinaz Afsari
- a Cellular and Molecular Research Centre, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences , Tehran , Iran
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Ozer B, Sezerman OU. A novel analysis strategy for integrating methylation and expression data reveals core pathways for thyroid cancer aetiology. BMC Genomics 2015; 16 Suppl 12:S7. [PMID: 26678064 PMCID: PMC4682414 DOI: 10.1186/1471-2164-16-s12-s7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Recently, a wide range of diseases have been associated with changes in DNA methylation levels, which play a vital role in gene expression regulation. With ongoing developments in technology, attempts to understand disease mechanism have benefited greatly from epigenetics and transcriptomics studies. In this work, we have used expression and methylation data of thyroid carcinoma as a case study and explored how to optimally incorporate expression and methylation information into the disease study when both data are available. Moreover, we have also investigated whether there are important post-translational modifiers which could drive critical insights on thyroid cancer genetics. Results In this study, we have conducted a threshold analysis for varying methylation levels to identify whether setting a methylation level threshold increases the performance of functional enrichment. Moreover, in order to decide on best-performing analysis strategy, we have performed data integration analysis including comparison of 10 different analysis strategies. As a result, combining methylation with expression and using genes with more than 15% methylation change led to optimal detection rate of thyroid-cancer associated pathways in top 20 functional enrichment results. Furthermore, pooling the data from different experiments increased analysis confidence by improving the data range. Consequently, we have identified 207 transcription factors and 245 post-translational modifiers with more than 15% methylation change which may be important in understanding underlying mechanisms of thyroid cancer. Conclusion While only expression or only methylation information would not reveal both primary and secondary mechanisms involved in disease state, combining expression and methylation led to a better detection of thyroid cancer-related genes and pathways that are found in the recent literature. Moreover, focusing on genes that have certain level of methylation change improved the functional enrichment results, revealing the core pathways involved in disease development such as; endocytosis, apoptosis, glutamatergic synapse, MAPK, ErbB, TGF-beta and Toll-like receptor pathways. Overall, in addition to novel analysis framework, our study reveals important thyroid-cancer related mechanisms, secondary molecular alterations and contributes to better knowledge of thyroid cancer aetiology.
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Abstract
Medullary thyroid carcinoma (MTC) is a rare malignancy originating from the calcitonin-secreting parafollicular thyroid C cells. Approximately 75% of cases are sporadic. Rearranged during transfection (RET) proto-oncogene plays a crucial role in MTC development. Besides RET, other oncogenes commonly involved in the pathogenesis of human cancers have also been investigated in MTC. The family of human RAS genes includes the highly homologous HRAS, KRAS, and NRAS genes that encode three distinct proteins. Activating mutations in specific hotspots of the RAS genes are found in about 30% of all human cancers. In thyroid neoplasias, RAS gene point mutations, mainly in NRAS, are detected in benign and malignant tumors arising from the follicular epithelium. However, recent reports have also described RAS mutations in MTC, namely in HRAS and KRAS. Overall, the prevalence of RAS mutations in sporadic MTC varies between 0-43.3%, occurring usually in tumors with WT RET and rarely in those harboring a RET mutation, suggesting that activation of these proto-oncogenes represents alternative genetic events in sporadic MTC tumorigenesis. Thus, the assessment of RAS mutation status can be useful to define therapeutic strategies in RET WT MTC. MTC patients with RAS mutations have an intermediate risk for aggressive cancer, between those with RET mutations in exons 15 and 16, which are associated with the worst prognosis, and cases with other RET mutations, which have the most indolent course of the disease. Recent results from exome sequencing indicate that, besides mutations in RET, HRAS, and KRAS, no other recurrent driver mutations are present in MTC.
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Affiliation(s)
- Margarida M Moura
- Unidade de Investigação em Patobiologia Molecular (UIPM)Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023 Lisboa, PortugalServiço de EndocrinologiaInstituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023 Lisboa, PortugalClínica Universitária de EndocrinologiaFaculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1150-228 Lisboa, Portugal
| | - Branca M Cavaco
- Unidade de Investigação em Patobiologia Molecular (UIPM)Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023 Lisboa, PortugalServiço de EndocrinologiaInstituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023 Lisboa, PortugalClínica Universitária de EndocrinologiaFaculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1150-228 Lisboa, Portugal
| | - Valeriano Leite
- Unidade de Investigação em Patobiologia Molecular (UIPM)Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023 Lisboa, PortugalServiço de EndocrinologiaInstituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023 Lisboa, PortugalClínica Universitária de EndocrinologiaFaculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1150-228 Lisboa, Portugal Unidade de Investigação em Patobiologia Molecular (UIPM)Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023 Lisboa, PortugalServiço de EndocrinologiaInstituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023 Lisboa, PortugalClínica Universitária de EndocrinologiaFaculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1150-228 Lisboa, Portugal Unidade de Investigação em Patobiologia Molecular (UIPM)Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023 Lisboa, PortugalServiço de EndocrinologiaInstituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Rua Prof. Lima Basto, 1099-023 Lisboa, PortugalClínica Universitária de EndocrinologiaFaculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria 130, 1150-228 Lisboa, Portugal
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