Yamauchi Mayu, Sakai Akihiro, Ebisumoto Koji, Iijima Hiroaki, Teramura Takanobu, Yamazaki Aritomo, Yanagiya Ryoko, Yamamoto Ai, Ota Yoshiyuki, Ashida Hiroshi, Kobayashi Naoya, Okami Kenji
Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Tokai University, Isehara 259-1193, Japan.
Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Tokai University, Isehara 259-1193, Japan.
Auris Nasus Larynx. 2024 Dec;51(6):1003-1008. doi: 10.1016/j.anl.2024.10.002. Epub 2024 Oct 23.
Anaplastic thyroid cancer (ATC) is an aggressive malignancy with a poor prognosis and limited treatment options. Herein, we report two cases of unresectable ATC treated with a combination of BRAF and MEK inhibitors. The patients were initially treated with other therapies but were switched to BRAF and MEK inhibitors after testing positive for BRAF mutations. This resulted in a partial response, tumor shrinkage, and conversion to resectability in one case. The patient experienced manageable adverse events. BRAF mutations are common in thyroid cancers, and studies have demonstrated the efficacy of combining BRAF and MEK inhibitors for treating advanced or recurrent differentiated thyroid cancer or ATC with BRAF mutations. These cases emphasize the importance of BRAF gene testing at the initial diagnosis and the potential of BRAF and MEK inhibitors as treatment options for unresectable ATC with BRAF mutations. The oral administration and manageable adverse event profiles of these medications make them suitable for outpatient treatment. In conclusion, BRAF gene testing should be performed at the initial diagnosis, and the use of BRAF and MEK inhibitors should be considered in patients with ATC.
间变性甲状腺癌(ATC)是一种侵袭性恶性肿瘤,预后较差,治疗选择有限。在此,我们报告两例不可切除的ATC患者,采用BRAF和MEK抑制剂联合治疗。这两名患者最初接受了其他治疗,但在BRAF突变检测呈阳性后改用BRAF和MEK抑制剂治疗。这导致了部分缓解、肿瘤缩小,其中一例患者的肿瘤转变为可切除。该患者经历了可控制的不良事件。BRAF突变在甲状腺癌中很常见,研究已经证明,BRAF和MEK抑制剂联合使用对治疗晚期或复发性分化型甲状腺癌或具有BRAF突变的ATC有效。这些病例强调了在初诊时进行BRAF基因检测的重要性,以及BRAF和MEK抑制剂作为具有BRAF突变的不可切除ATC治疗选择的潜力。这些药物的口服给药方式和可控制的不良事件特征使其适用于门诊治疗。总之,初诊时应进行BRAF基因检测,对于ATC患者应考虑使用BRAF和MEK抑制剂。