Locally unresectable differentiated thyroid cancer: outcomes and perspectives

Area of Science:

• Oncology
• Endocrinology
• Cancer Research

Background:

• Differentiated thyroid cancer (DTC) patients with unresectable primary tumors face limited treatment options due to ineligibility for surgery and radioiodine therapy.
• Local invasion often excludes these patients from clinical trials, further restricting therapeutic strategies.

Purpose of the Study:

• To characterize the clinical features and prognosis of patients diagnosed with locally unresectable differentiated thyroid cancer.
• To evaluate treatment outcomes in a cohort of patients with advanced DTC.

Main Methods:

• A retrospective, multicentric analysis was conducted on consecutive unresectable DTC cases diagnosed between 2000 and 2015.
• Data on patient demographics, tumor histology, treatments received, and survival outcomes were collected and analyzed.

Main Results:

• The study included 22 patients (median age 77 years), with papillary, follicular, Hürthle cell, and poorly differentiated subtypes observed.
• Treatments included external beam radiation therapy (EBRT), locoregional therapy for metastases, chemotherapy, and tyrosine kinase inhibitors (TKIs).
• TKI treatment demonstrated a median disease control of 7 months with 44% grade 3-4 toxicity. Overall 1, 3, and 5-year survival rates were 81%, 27.7%, and 21.5%, respectively, with no treatment-related deaths.

Conclusions:

• There is a significant unmet need for clinical trials and approved therapies for unresectable DTC.
• Tyrosine kinase inhibitors (TKIs) show potential for prolonging disease control in unresectable DTC patients, with acceptable toxicity profiles.