Lorimer C, Cheng L, Chandler R, Garcez K, Gill V, Graham K, Grant W, Sardo Infirri S, Wadsley J, Wall L, Webber N, Wong K H, Newbold K
The Royal Marsden Hospital, London, UK.
The Royal Marsden Hospital, London, UK.
Clin Oncol (R Coll Radiol). 2023 Jan;35(1):e60-e66. doi: 10.1016/j.clon.2022.10.017. Epub 2022 Nov 12.
Anaplastic thyroid cancer (ATC) is a rare but aggressive form of thyroid cancer with a median survival of 4 months. Recent advances in molecular profiling have shown that up to half of ATCs harbour the BRAF-V600E mutation. The aim of this study was to provide real-world data and experience on the use of combination therapy dabrafenib and trametinib in patients with BRAF-V600E-mutated advanced ATC.
We retrospectively evaluated patients with confirmed BRAF-V600E-mutated ATC, defined as patients with locally advanced or metastatic ATC with no locoregional, radical treatment options. Outcomes measured were overall survival, progression-free survival, response rate, discontinuation rate, dose reduction rate and toxicity data.
Seventeen patients were evaluated and the mean age was 68 years. Ten patients died by the time of censoring. The median duration of follow-up was 12 months (3-43 months). The estimated median overall survival was 6.9 months (95% confidence interval 2.46 months - upper confidence interval not reached) and the median progression-free survival was 4.7 months (95% confidence interval 1.4-7.8 months). Dose interruptions and/or reductions were common, but none of the patients had to permanently discontinue treatment because of toxicities. Severe toxicities (grades 3 and 4) were uncommon.
This study supports the indication of dabrafenib and trametinib in BRAF-V600E-mutated ATC as an effective and well-tolerated treatment in an historically difficult to treat cancer.
间变性甲状腺癌(ATC)是一种罕见但侵袭性强的甲状腺癌,中位生存期为4个月。分子谱分析的最新进展表明,高达一半的ATC患者携带BRAF-V600E突变。本研究的目的是提供关于联合使用达拉非尼和曲美替尼治疗BRAF-V600E突变的晚期ATC患者的真实世界数据和经验。
我们回顾性评估了确诊为BRAF-V600E突变的ATC患者,定义为局部晚期或转移性ATC且无局部区域根治性治疗选择的患者。测量的结果包括总生存期、无进展生存期、缓解率、停药率、剂量降低率和毒性数据。
共评估了17例患者,平均年龄为68岁。到审查时,有10例患者死亡。中位随访时间为12个月(3 - 43个月)。估计的中位总生存期为6.9个月(95%置信区间2.46个月 - 上置信区间未达到),中位无进展生存期为4.7个月(95%置信区间1.4 - 7.8个月)。剂量中断和/或减少很常见,但没有患者因毒性而不得不永久停药。严重毒性(3级和4级)并不常见。
本研究支持达拉非尼和曲美替尼在BRAF-V600E突变的ATC中的应用,作为一种在历史上难以治疗的癌症中有效且耐受性良好的治疗方法。