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Review
. 2022 Feb 19;14(4):1061.
doi: 10.3390/cancers14041061.

Anaplastic Thyroid Carcinoma: An Update

Arnaud Jannin  1   2 , Alexandre Escande  2   3 , Abir Al Ghuzlan  4 , Pierre Blanchard  5 , Dana Hartl  6 , Benjamin Chevalier  1   2 , Frédéric Deschamps  7 , Livia Lamartina  8 , Ludovic Lacroix  9 , Corinne Dupuy  10 , Eric Baudin  8 , Christine Do Cao  1 , Julien Hadoux  8
Affiliations
Review

Anaplastic Thyroid Carcinoma: An Update

Arnaud Jannin et al. Cancers (Basel). .

Abstract

Anaplastic thyroid carcinoma (ATC) is a rare and undifferentiated form of thyroid cancer. Its prognosis is poor: the median overall survival (OS) of patients varies from 4 to 10 months after diagnosis. However, a doubling of the OS time may be possible owing to a more systematic use of molecular tests for targeted therapies and integration of fast-track dedicated care pathways for these patients in tertiary centers. The diagnostic confirmation, if needed, requires an urgent biopsy reread by an expert pathologist with additional immunohistochemical and molecular analyses. Therapeutic management, defined in multidisciplinary meetings, respecting the patient's choice, must start within days following diagnosis. For localized disease diagnosed after primary surgical treatment, adjuvant chemo-radiotherapy is recommended. In the event of locally advanced or metastatic disease, the prognosis is very poor. Treatment should then involve chemotherapy or targeted therapy and decompressive cervical radiotherapy. Here we will review current knowledge on ATC and provide perspectives to improve the management of this deadly disease.

Keywords: anaplastic thyroid carcinoma; chemotherapy; immune checkpoint inhibitors; molecular targeted therapy; radiotherapy; tumors associated macrophages.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
CT scan illustration of anaplastic thyroid carcinoma (ATC) staging.
Figure 2
Figure 2
Illustration of 18FDG PET/CT anaplastic thyroid carcinoma (ATC) response to chemotherapy and radiotherapy before surgery. The figure represents axial (A) and coronal (B) slices of the neck region with an ATC volume of 230 mL before initiating treatment comprising chemotherapy (Cisplatin-Doxorubicin, 2 cures) and radiotherapy (IMRT, 50 Gy. (C,D) represent axial (C) and coronal slices (D) of the neck region with an ATC volume of 15 mL.
Figure 3
Figure 3
Initial treatment of stages IVa, IVb and IVc ATC, adapted from [2].
Figure 4
Figure 4
Molecular and treatment landscape of ATC (based on [2]). ATC: Anaplastic Thyroid Carcinoma, L1 and L2: Line of treatment one or two, IMRT: Intensity-Modulated Radiation Therapy, PD-L1: Programmed Death-Ligand 1.
See this image and copyright information in PMC

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