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Review
. 2021 Jun 26;13(13):3200.
doi: 10.3390/cancers13133200.

Poorly Differentiated and Anaplastic Thyroid Cancer: Insights into Genomics, Microenvironment and New Drugs

Alessandro Prete  1 , Antonio Matrone  1 , Carla Gambale  1 , Liborio Torregrossa  2 , Elisa Minaldi  1 , Cristina Romei  1 , Raffaele Ciampi  1 , Eleonora Molinaro  1 , Rossella Elisei  1
Affiliations
Review

Poorly Differentiated and Anaplastic Thyroid Cancer: Insights into Genomics, Microenvironment and New Drugs

Alessandro Prete et al. Cancers (Basel). .

Abstract

PDTC and ATC present median overall survival of 6 years and 6 months, respectively. In spite of their rarity, patients with PDTC and ATC represent a significant clinical problem, because of their poor survival and the substantial inefficacy of classical therapies. We reviewed the newest findings about genetic features of PDTC and ATC, from mutations occurring in DNA to alterations in RNA. Therefore, we describe their tumor microenvironments (both immune and not-immune) and the interactions between tumor and neighboring cells. Finally, we recapitulate how this upcoming evidence are changing the treatment of PDTC and ATC.

Keywords: anaplastic thyroid cancer; genetic landscape; genetically guided therapy; poorly thyroid cancer; tumor microenvironment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A–C) Anaplastic thyroid carcinoma (ATC) (hematoxylin and eosin stain); (A) The presence of extensive tumor necrosis is a typical aspect of ATC (see asterisk *) (original magnification ×10); (B) The neoplastic cells show marked nuclear atypia with spindled and pleomorphic morphology, associated to elevated mitotic rate, simulating high-grade pleomorphic sarcoma. In the insert, focal immunostaining for cytokeratins supports the epithelial nature of ATC (original magnification ×20); (C) At higher magnification, the pronounced nuclear atypia and an atypical mitosis (see arrow) are shown (original magnification ×40). (D–F) Poorly differentiated thyroid carcinoma (PDTC) (hematoxylin and eosin stain); (D) The typical example of PDTC is the so-called “insular carcinoma”. In this field, the tumor shows a small focus of tumor necrosis (see asterisk *) (original magnification ×10); (E) The neoplasm exhibits a prevalent solid growth pattern (original magnification ×20); (F) At higher magnification, the tumor cells appear small and uniform, the nuclei are generally rounded and hyperchromatic, in absence of the typical aspects of papillary thyroid carcinoma (original magnification ×40).
Figure 2
Figure 2
miRNA that were discovered in ATC according to their function.
Figure 3
Figure 3
All innovative therapies that have been suggested in ATC and PDTC (rectangular box with dotted lines); each of them has been related to a specific inhibition of hallmark of cancer (triangle box) and cellular pathway (rectangular box).
See this image and copyright information in PMC

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