Endocrine Abstracts

Introduction: The importance of telomerase reverse transcriptase promoter (TERTp) mutations in DTC is widely discussed. It has been demonstrated that the presence of TERTp mutations is associated with higher cancer aggressiveness, reflected by lymph node metastases, distant metastases, advanced tumor stage, recurrence, and even disease-specific mortality. Nevertheless, there is no clear evidence-based data demonstrating how to manage these patients. Therefore, we decided to carry out a single-center, prospective, pilot study. Its primary aim is to evaluate the predictive value of TERTp mutations in DTC. Secondary aim is to answer the following questions:

• Whether the sensitivity of Sanger sequencing in diagnostics TERTp mutations in FNAB specimen is sufficient to make clinical decisions?

• Whether the presence of TERTp mutations influence RAI avidity in DTC?

• Whether the presence of TERTp mutations justify broader indications for RAI complementary treatment?

• Whether more aggressive treatment and follow-up influences long term outcomes?

Material and the study scheme: The study group will involve 60 DTC patients, 30 TERTp positive and 30 TERTp negative. The aim of the first stage is to evaluate the sensitivity of Sanger sequencing in diagnostics of TERTp mutations in FNAB specimen and to compare the impact on RAI avidity by comparison of TERT negative and TERT positive groups. The purpose of the second part is to compare treatment outcomes, based on ATA response criteria, in TERTp positive group between patients treated according to standard protocol and those subjected to more intensive therapy and follow-up.