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. 2023 Sep;81(3):450-454.
doi: 10.1007/s12020-023-03388-6. Epub 2023 May 16.

Add-on radioiodine during long-term BRAF/MEK inhibition in patients with RAI-refractory thyroid cancers: a reasonable option?

Filipe Miguel Montes de Jesus  1 , Vittoria Espeli  2 , Gaetano Paone  1 , Luca Giovanella  3   4
Affiliations

Add-on radioiodine during long-term BRAF/MEK inhibition in patients with RAI-refractory thyroid cancers: a reasonable option?

Filipe Miguel Montes de Jesus et al. Endocrine. 2023 Sep.

Abstract

Dual modulation of the MAPK pathway with BRAF (e.g., dabrafenib) and MEK (e.g., trametinib) inhibitors has the potential to re-establish radioiodine (RAI) sensitivity in BRAF-mutated RAI-refractory (RAI-R)-differentiated thyroid carcinoma (DTC) cells. Here we showed that (1) double BRAF/MEK inhibition may still reach a significant redifferentiation in patients with a long-history RAI-R DTC and multiple previous treatments; (2) the addition of high RAI activities may obtain a significant structural response in such patients; and (3) a divergence between increasing thyroglobulin and structural response may be a reliable biomarker or redifferentiation. Accordingly, the add-on prescription of high activities of 131I should be considered in RAI-R patients under multikinase inhibitors with stable or responding structural disease and divergent increase of Tg levels.

Keywords: Dedifferentiation; Differentiated thyroid carcinoma; Radioiodine; Radioiodine-refractory-differentiated thyroid carcinoma.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Overview of biochemical and imaging findings
See this image and copyright information in PMC

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