دورية أكاديمية
Salutary Response to Targeted Therapy in Anaplastic Thyroid Cancer
العنوان: | Salutary Response to Targeted Therapy in Anaplastic Thyroid Cancer |
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المؤلفون: | Sasan Fazeli MD, Edina Paal MD, Jessica H. Maxwell MD, Kenneth D. Burman MD, Eric S. Nylen MD, Shikha G. Khosla MD, MHA |
المصدر: | Journal of Investigative Medicine High Impact Case Reports, Vol 7 (2019) |
بيانات النشر: | SAGE Publishing, 2019. |
سنة النشر: | 2019 |
المجموعة: | LCC:Medicine (General) LCC:Pathology |
مصطلحات موضوعية: | Medicine (General), R5-920, Pathology, RB1-214 |
الوصف: | Context . Anaplastic thyroid cancer (ATC) is an aggressive tumor with a median survival of 3 to 9 months, a 1-year survival of less than 10% and without definitive therapies. Recently, in BRAF V600E mutated ATCs, new targeted therapy using a combination of a BRAF inhibitor, dabrafenib (Dab), with a mitogen-activated extracellular protein kinase (MEK) inhibitor, trametinib (Tram), has shown significant promise. Case Description . We report a case of aggressive ATC with 5 sequence mutations: BRAF V600E (mutation fraction [MF] 34%), TERT E441del (MF 37%), RET N579K (MF 55%), EZH2 D154E (MF 60%), and CDK4 S259L (MF 48%). The patient had a dramatic response to the Dab/Tram combination with near complete resolution of his lung, bone, hepatic, and splenic lesions soon after starting therapy. Unfortunately, intolerable side effects (grade 2-3) on this regimen required tapering and discontinuation of the treatment. He had a quick resurgence of disease after stopping the combination therapy. The patient died approximately 3 months after discontinuing Dab/Tram. Autopsy revealed an atrophic thyroid gland with microscopic subcapsular focus of well-differentiated papillary thyroid carcinoma. There was extensive lymphatic spread of the tumor throughout bilateral lungs with fibrosis. No other metastatic site was identified. Conclusion . We report a unique case of ATC with 2 new mutations of EZH2 D154E and CDK S529L . This case exemplifies the significant promise Dab/Tram therapy holds, the potential side effects that limit their use, and autopsy findings status post use of this combination therapy. |
نوع الوثيقة: | article |
وصف الملف: | electronic resource |
اللغة: | English |
تدمد: | 2324-7096 23247096 |
Relation: | https://doaj.org/toc/2324-7096 |
DOI: | 10.1177/2324709619890942 |
URL الوصول: | https://doaj.org/article/a8688cca4a1848e8b639b3f7a67218b3 |
رقم الأكسشن: | edsdoj.8688cca4a1848e8b639b3f7a67218b3 |
قاعدة البيانات: | Directory of Open Access Journals |
تدمد: | 23247096 |
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DOI: | 10.1177/2324709619890942 |