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Multicenter Study
. 2021 Jun 25;100(25):e26388.
doi: 10.1097/MD.0000000000026388.

Next-generation sequencing in thyroid cancers: do targetable alterations lead to a therapeutic advantage?: A multicenter experience

Assaf Moore  1   2 , Yael Bar  2   3 , Corinne Maurice-Dror  4   5 , Inbar Finkel  1 , Hadar Goldvaser  6   7 , Elizabeth Dudnik  1   2 , Daniel A Goldstein  1   2 , Noa Gordon  1 , Salem Billan  4   5 , Orit Gutfeld  2   3 , Ido Wolf  2   3 , Aron Popovtzer  1   2
Affiliations
Multicenter Study

Next-generation sequencing in thyroid cancers: do targetable alterations lead to a therapeutic advantage?: A multicenter experience

Assaf Moore et al. Medicine (Baltimore). .

Abstract

Radioiodine-refractory thyroid cancers (IRTCs) are uncommon and have a poor prognosis. Treatment options for radioiodine-refractory and anaplastic tumors (ATCs) are limited. Although the genomic landscape of thyroid cancer has been studied, there is little evidence on whether next-generation sequencing (NGS) findings translate to tumor control.We analyzed all patients with IRTC and ATC who underwent commercially available NGS in 3 cancer centers.Twenty-two patients were identified, 16 patients with IRTCs and 6 patients with ATCs. Eighteen (82%) had targetable findings in NGS, nine patients were treated accordingly. Median progression-free survival for targeted treatment was 50 months [95% confidence interval (CI95%) 9.8-66.6] and2 months (CI95% 0.2-16.5) for IRTC and ATC, respectively. Of 4 patients who achieved durable responses of 7 to 50 months, 2 are ongoing. The estimated median OS of IRTC receiving targeted treatment was not reached (CI95% 89.7-111.4 months) and was 77.8 months (CI95% 52.5-114.6) for patients treated conventionally (P = .3).NGS may detect clinically significant genetic alterations and benefit patients with advanced thyroid cancers.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Swimmer plot. NGS-guided treatment. PD = progressive disease, PR = partial response.
Figure 2
Figure 2
An ongoing response to a vemurafenib/cobimetinib combination in a patient with BRAF V600E mutated papillary thyroid cancer. (A) A baseline PET-CT scan (12/2016) demonstrating a right upper lobe (RUL_ mass extending into the mediastinum. (B) A baseline PET-CT scan (12/2016) demonstrating a left upper lobe (LUL) mass. (C) A PET-CT scan (4/2017) demonstrating a partial response in the RUL mass. (D) A PET-CT scan (4/2017) demonstrating a partial response in the LUL mass. (E) A PET-CT scan (4/2020) demonstrating an ongoing response in the RUL mass. (F) A PET-CT scan (4/2020) demonstrating an ongoing response in the LUL mass.
Figure 3
Figure 3
Overall survival of patients with radioiodine-refractory thyroid cancer. All patients - blue, median 108.6 months (CI95% 74.1–110.0); NGS-guided - green, median not reached (CI95% 89.7–111.4); conventional treatment - red, median 77.8 months (CI95% 52.5–114.6); pP = .3.
See this image and copyright information in PMC

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