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共识声明:甲状腺癌管理中可操作生物标志物检测的建议

Consensus Statement: Recommendations on Actionable Biomarker Testing for Thyroid Cancer Management.

作者信息

Mete Ozgur, Boucher Andrée, Schrader Kasmintan A, Abdel-Rahman Omar, Bahig Houda, Ho Cheryl, Hasan Olfat Kamel, Lemieux Bernard, Winquist Eric, Wong Ralph, Wu Jonn, Chau Nicole, Ezzat Shereen

机构信息

Department of Pathology, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Ontario, M5G 2C4, Canada.

Department of Medicine, Université de Montréal, Montreal, Quebec, Canada.

出版信息

Endocr Pathol. 2024 Dec;35(4):293-308. doi: 10.1007/s12022-024-09836-x. Epub 2024 Nov 23.

Abstract

Thyroid cancer management is rapidly changing. The identification of actionable biomarkers through both germline and somatic testing are now an integral part of directing patient management. However, deficiencies and disparities within existing thyroid cancer biomarker test approaches are resulting in inconsistent application for patient care. An expert panel was convened to create consensus biomarker testing algorithms and recommendations on actionable biomarker testing for patients diagnosed with medullary thyroid cancer, non-anaplastic follicular cell-derived thyroid cancer, or anaplastic follicular cell-derived thyroid cancer who may benefit from targeted therapies. A review of international guidelines was performed to determine the current state, and a literature review was carried out to further evaluate the evidence supporting the use of actionable biomarkers in patients diagnosed with thyroid cancer. Thyroid biomarker-related gaps impacting patient care were also discussed, with an emphasis on the importance of a multidisciplinary team approach for optimal patient care. The recommendations are presented with the aim to help physicians navigate the current thyroid cancer biomarker testing landscape with its many challenges, balancing aspirational care with what is practical and feasible in terms of economic realities and jurisdictional constraints. By remaining therapy-agnostic, these algorithms and recommendations are broadly applicable.

摘要

甲状腺癌的管理正在迅速变化。通过种系和体细胞检测来识别可采取行动的生物标志物,现已成为指导患者管理的一个组成部分。然而,现有甲状腺癌生物标志物检测方法存在的不足和差异,导致在患者护理中的应用不一致。为此召集了一个专家小组,以制定关于可采取行动的生物标志物检测的共识性检测算法和建议,用于可能从靶向治疗中获益的、被诊断为髓样甲状腺癌、非间变性滤泡细胞源性甲状腺癌或间变性滤泡细胞源性甲状腺癌的患者。对国际指南进行了审查以确定当前状况,并进行了文献综述以进一步评估支持在被诊断为甲状腺癌的患者中使用可采取行动的生物标志物的证据。还讨论了影响患者护理的甲状腺生物标志物相关差距,强调了多学科团队方法对优化患者护理的重要性。提出这些建议的目的是帮助医生应对当前甲状腺癌生物标志物检测领域面临的诸多挑战,在理想护理与经济现实和管辖限制方面实际可行的方案之间取得平衡。通过保持与治疗无关,这些算法和建议具有广泛的适用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d504/11659332/cf302e8afffb/12022_2024_9836_Fig1_HTML.jpg

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