ECEESPE2025 Poster Presentations Endocrine Related Cancer (76 abstracts)
Redifferentiation treatment in radioiodine refractory metastatic papillary thyroid cancer
Rosalía Vegara Fernandez 1 , Guadalupe Guijarro 1 , Miguel Soria Tristán 2 , Candida Paniagua Correa 3 , Jose Antonio Rosado 1 , Helena Urriza Blazquez 1 , Carmen Fernandez de Araoz 1 , PALOMA IGLESIAS BOLAÑOS 2 , Maria Merino Viveros 1 , Isabel Pavon de Paz 1 & Lucia Ribas 1
1Hospital Universitario de Getafe, Endocrinology and Metabolism, Getafe, Spain; 2Hospital Universitario de Getafe, Oncology, Getafe, Spain; 3Hospital Universitario de Getafe, Nuclear Medicine, Getafe, Spain
JOINT2492
Thyroid cancer is the most common endocrine cancer. Differentiated thyroid cancer (DTC), is by far the most common. DTC has an excellent prognosis, with a survival rate of more than 90% at 10 years. However, a minority of patients with DTC (<10%) develop distant metastases. The first-line treatment for metastatic thyroid disease is radioiodine. However, more than half of these lesions lose their avidity for radioiodine, becoming radiorefractory and in these cases survival decreases drastically. In the last decades much has been learned about the molecular pathways affected in DTC and their importance in the prognosis of these tumors. In particular, the BRAF mutation is highly frequent in DTC and seems be related to a worse prognosis of the disease. It also appears to be related to the risk of dedifferentiation of the lesions. In this context, drugs aimed at blocking these molecular points have been developed with the aim of inducing cell redifferentiation. The purpose of this study is to evaluate the efficacy of a redifferentiating treatment based on Dabrafenib and/or Trametinib during a short period of time in patients with BRAF or RAS mutated radioiodine refractory metastatic papillary thyroid cancer (PTC).
Methods: retrospective study including 13 patients under follow-up in the Endocrinology and Oncology Departments of the Hospital Universitario de Getafe diagnosed with radiorefractory metastatic PTC and BRAF or RAS mutation carriers, previously treated or not with systemic therapy. The selected patients receive redifferentiating treatment with Dabrafenib and/or Trametinib (depending on the mutation) for 6 weeks. Then, we perform a WBS with 5mCi of I31 and in case of increased I131 uptake, we scheduled an admission for administration of a therapeutic dose of I131 after stimulation with rTSH. Subsequently, redifferentiating treatment is suspended. The primary objective was to determine the increase in I131 uptake of the metastatic lesions after the redifferentiation process and to determine the response (according to RECIST and PRECIST criteria) to the new dose of I131.
Results: After redifferentiation treatment, I131 uptake increased in 5 patients (40%) all of whom received a therapeutic dose of I131. A sixth patient receives the dose empirically. Of the six patients receiving treatment with I131, according to RECIST criteria, 2 achieve partial response, 3 achieve stable disease and 1 has disease progression. According to PERCIST criteria, 4 achieve partial metabolic response, 1 achieves stable metabolic disease and 1 has disease progression.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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