PDF(Pubmed)
Abstract：
UNASSIGNED: Tyrosine kinase inhibitors (TKIs) and immunotherapy have been proposed for advanced metastatic anaplastic thyroid cancer (ATC). We report a case of BRAF V600E-mutated ATC in which lenvatinib (L) plus pembrolizumab (P) enabled neoadjuvant treatment.
UNASSIGNED: A male patient aged 65 years presented with a rapidly enlarging left latero-cervical mass. Fine needle aspiration was suggestive of ATC. Surgical consultation excluded radical surgery. While awaiting molecular profile analysis and considering the fast evolution of the disease, treatment with L and P was started. L was started at a dose of 14 mg daily, while P was started at the standard regimen (200 mg every 3 weeks). After 1 month, computerized tomography showed a reduction in the mass with almost complete colliquative degeneration, and the carotid artery wall was free from infiltration. Radical surgery was performed. Histology confirmed papillary thyroid cancer (PTC) in the left lobe and ATC with extensive necrosis in the left latero-cervical lymph node metastasis. The margins were free of tumors (R0). A BRAF V600E mutation was present in both PTC and ATC. At the 1-year follow-up, the patient was free of disease.
UNASSIGNED: L and P in combination also appeared to be effective as a neoadjuvant treatment for BRAF V600E-mutated ATC. This combination treatment could be used when there is an opportunity for complete resection of the cancer, and as soon as possible. The intermediate dose of 14 mg of L appeared to be well tolerated and effective.
UNASSIGNED: A male patient aged 65 years presented with a rapidly enlarging left latero-cervical mass. Fine needle aspiration was suggestive of ATC. Surgical consultation excluded radical surgery. While awaiting molecular profile analysis and considering the fast evolution of the disease, treatment with L and P was started. L was started at a dose of 14 mg daily, while P was started at the standard regimen (200 mg every 3 weeks). After 1 month, computerized tomography showed a reduction in the mass with almost complete colliquative degeneration, and the carotid artery wall was free from infiltration. Radical surgery was performed. Histology confirmed papillary thyroid cancer (PTC) in the left lobe and ATC with extensive necrosis in the left latero-cervical lymph node metastasis. The margins were free of tumors (R0). A BRAF V600E mutation was present in both PTC and ATC. At the 1-year follow-up, the patient was free of disease.
UNASSIGNED: L and P in combination also appeared to be effective as a neoadjuvant treatment for BRAF V600E-mutated ATC. This combination treatment could be used when there is an opportunity for complete resection of the cancer, and as soon as possible. The intermediate dose of 14 mg of L appeared to be well tolerated and effective.
摘要：
已经提出了酪氨酸激酶抑制剂(TKIs)和免疫疗法用于晚期转移性间变性甲状腺癌(ATC)。我们报告了一例BRAFV600E突变的ATC，其中lenvatinib（L）加pembrolizumab（P）使新辅助治疗成为可能。
■一名65岁的男性患者，表现为左侧宫颈后肿块迅速扩大。细针抽吸提示ATC。手术会诊排除根治性手术。在等待分子谱分析并考虑疾病的快速发展时，开始用L和P治疗。L以每天14毫克的剂量开始，而P开始于标准方案（200mg每3周）。一个月后,计算机断层扫描显示肿块减少，几乎完全准直性变性，颈动脉壁无浸润。进行了根治性手术。组织学证实左叶甲状腺乳头状癌（PTC）和ATC，左颈后淋巴结转移广泛坏死。边缘无肿瘤(R0)。在PTC和ATC中均存在BRAFV600E突变。在1年的随访中，病人没有疾病。
■L和P联合作为BRAFV600E突变的ATC的新辅助治疗似乎也是有效的。当有机会完全切除癌症时，可以使用这种联合治疗，并尽快。14mgL的中间剂量似乎耐受良好且有效。
■一名65岁的男性患者，表现为左侧宫颈后肿块迅速扩大。细针抽吸提示ATC。手术会诊排除根治性手术。在等待分子谱分析并考虑疾病的快速发展时，开始用L和P治疗。L以每天14毫克的剂量开始，而P开始于标准方案（200mg每3周）。一个月后,计算机断层扫描显示肿块减少，几乎完全准直性变性，颈动脉壁无浸润。进行了根治性手术。组织学证实左叶甲状腺乳头状癌（PTC）和ATC，左颈后淋巴结转移广泛坏死。边缘无肿瘤(R0)。在PTC和ATC中均存在BRAFV600E突变。在1年的随访中，病人没有疾病。
■L和P联合作为BRAFV600E突变的ATC的新辅助治疗似乎也是有效的。当有机会完全切除癌症时，可以使用这种联合治疗，并尽快。14mgL的中间剂量似乎耐受良好且有效。
