Exceptional response to vemurafenib and cobimetinib in anaplastic thyroid cancer 40 years after treatment for papillary thyroid cancer

We present an unusual case of a patient that developed anaplastic thyroid cancer 40 years after treatment for papillary thyroid cancer. The patient presented with locoregional recurrence and distant metastasis. Tumor genotyping identified a V600E mutation. The patient was treated with drugs targetin...

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Bibliographic Details
Published in:International journal of endocrine oncology 2017-11, Vol.4 (4), p.159-165
Main Authors: Green, Patience, Schwartz, Richard H, Shell, Jasmine, Allgauer, Michael, Chong, Daniel, Kebebew, Electron
Format: Article
Language:English
Subjects:
anaplastic thyroid cancer
BRAF
de-differentiation
Family medical history
Iodine
Lymphatic system
Medical imaging
Medical prognosis
Metastasis
Mutation
Neck
NMR
Nuclear magnetic resonance
papillary thyroid cancer
Patients
Surveillance
Thyroid cancer
Tomography
Tumors
vemurafenib
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Summary:We present an unusual case of a patient that developed anaplastic thyroid cancer 40 years after treatment for papillary thyroid cancer. The patient presented with locoregional recurrence and distant metastasis. Tumor genotyping identified a V600E mutation. The patient was treated with drugs targeting BRAF V600E and MEK (vemurafenib and cobimetinib, respectively). The patient had a remarkable response with the right neck tumor shrinking 81% in size and disappearance of the distant metastases over an 8-month period. The patient underwent surgical resection of the residual tumor with genetic testing of the specimen showing persistent V600E mutation population of cells. Targeted drug therapy has been used with discretion on a case-by-case basis for anaplastic thyroid cancer and may result in good tumor response.
ISSN:2045-0869
2045-0877
DOI:10.2217/ije-2017-0016