Next-generation sequencing in thyroid cancers: do targetable alterations lead to a therapeutic advantage?: A multicenter experience

• Published in: Medicine (Baltimore) 2021-06, Vol.100 (25), p.e26388-e26388
• Main Authors: Moore, Assaf, Bar, Yael, Maurice-Dror, Corinne, Finkel, Inbar, Goldvaser, Hadar, Dudnik, Elizabeth, Goldstein, Daniel A., Gordon, Noa, Billan, Salem, Gutfeld, Orit, Wolf, Ido, Popovtzer, Aron
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Agents, Immunological - pharmacology; Antineoplastic Agents, Immunological - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - pharmacology; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers, Tumor - antagonists & inhibitors; Biomarkers, Tumor - genetics; Chemoradiotherapy - methods; DNA Mutational Analysis; Female; High-Throughput Nucleotide Sequencing; Humans; Iodine Radioisotopes - pharmacology; Iodine Radioisotopes - therapeutic use; Israel - epidemiology; Male; Middle Aged; Molecular Targeted Therapy - methods; Mutation; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - genetics; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - therapy; Observational Study; Progression-Free Survival; Protein Kinase Inhibitors - pharmacology; Protein Kinase Inhibitors - therapeutic use; Radiation Tolerance - drug effects; Radiation Tolerance - genetics; Retrospective Studies; Thyroid Gland - pathology; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - genetics; Thyroid Neoplasms - mortality; Thyroid Neoplasms - therapy
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000026388

Radioiodine-refractory thyroid cancers (IRTCs) are uncommon and have a poor prognosis. Treatment options for radioiodine-refractory and anaplastic tumors (ATCs) are limited. Although the genomic landscape of thyroid cancer has been studied, there is little evidence on whether next-generation sequencing (NGS) findings translate to tumor control.We analyzed all patients with IRTC and ATC who underwent commercially available NGS in 3 cancer centers.Twenty-two patients were identified, 16 patients with IRTCs and 6 patients with ATCs. Eighteen (82%) had targetable findings in NGS, nine patients were treated accordingly. Median progression-free survival for targeted treatment was 50 months [95% confidence interval (CI95%) 9.8-66.6] and2 months (CI95% 0.2-16.5) for IRTC and ATC, respectively. Of 4 patients who achieved durable responses of 7 to 50 months, 2 are ongoing. The estimated median OS of IRTC receiving targeted treatment was not reached (CI95% 89.7-111.4 months) and was 77.8 months (CI95% 52.5-114.6) for patients treated conventionally (P = .3).NGS may detect clinically significant genetic alterations and benefit patients with advanced thyroid cancers.