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Updated: Jun 10, 2025
Spontaneous Murine Model of Anaplastic Thyroid Cancer
Published on: February 3, 2023
Combination kinase inhibitors and immunotherapy for unresectable anaplastic thyroid carcinoma: A retrospective
Yuntao Song1, Yabing Zhang1, Yanhua Bai2
1Department of Head and Neck Surgery, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing, China.
Introduction:
Anaplastic thyroid carcinoma (ATC) is rare but has a very poor prognosis. New therapeutic options such as multikinase inhibitors and selective tyrosine kinase inhibitors have revolutionized the treatment of ATC, with immunotherapy also showing encouraging effects. This study evaluated the efficacy and safety of kinase inhibitors combined with an anti-PD-1 inhibitor as first-line treatment, as well as in the neoadjuvant setting for patients with unresectable ATC.
Materials & Methods:
This retrospective single-center study recruited consecutive patients with stage IVB and IVC ATC who received first-line kinase inhibitors plus immunotherapy between June 2021 and June 2023. The patients were treated with either selective or multi-kinase inhibitors (dabrafenib/trametinib, lenvatinib, or anlotinib) in combination with one immune checkpoint inhibitor (pembrolizumab, sintilimab, or camrelizumab). The endpoints included overall survival (OS), progression-free survival (PFS), response evaluation, and feasibility of R0/R1 resection.
Results:
Eighteen patients were included in this analysis. The median OS (mOS) was 14.0 months and the 12-month survival rate was 55.6 %. The mOS in BRAF V600E mutated ATC was not reached, significantly longer than non-BRAF V600E mutated ATC (4.0 months [95 %CI, 1.1-6.9], p = 0.049). Among evaluable patients, 5 achieved a complete response (CR) and 6 patients achieved partial response (PR). The best ORR was 61.1 %. Surgical resection was feasible in 7/18 (38.9 %) patients. One grade 5 adverse event (AE) occurred. Most AEs were well tolerated.
Conclusions:
Combination kinase inhibitors with immunotherapy as first-line therapy are safe and effective for the treatment of unresectable ATC, especially with BRAF V600E mutation.
Insights
Combination therapy of kinase inhibitors and immunotherapy shows promise for unresectable anaplastic thyroid carcinoma (ATC). This approach is safe and effective, particularly for patients with BRAF V600E mutations.
Area of Science:
- Oncology
- Thyroid Cancer Research
- Cancer Therapeutics
Background:
- Anaplastic thyroid carcinoma (ATC) is a rare but aggressive cancer with a poor prognosis.
- Recent advancements include multikinase inhibitors, selective tyrosine kinase inhibitors, and immunotherapy.
- Evaluating novel combination therapies is crucial for improving patient outcomes.
Purpose of the Study:
- To assess the efficacy and safety of combining kinase inhibitors with anti-PD-1 immunotherapy.
- To investigate this combination as a first-line treatment for unresectable ATC.
- To evaluate its potential in the neoadjuvant setting for resectable disease.
Main Methods:
- Retrospective single-center study of consecutive patients with stage IVB/IVC ATC.
- Treatment involved kinase inhibitors (dabrafenib/trametinib, lenvatinib, anlotinib) plus immune checkpoint inhibitors (pembrolizumab, sintilimab, camrelizumab).
- Endpoints included overall survival (OS), progression-free survival (PFS), response evaluation, and R0/R1 resection feasibility.
Main Results:
- Median OS was 14.0 months, with a 12-month survival rate of 55.6%.
- Patients with BRAF V600E mutation had significantly longer mOS (not reached) compared to non-mutated (4.0 months).
- Overall response rate (ORR) was 61.1% (5 complete, 6 partial responses); surgical resection was feasible in 38.9%.
Conclusions:
- Combination therapy of kinase inhibitors and immunotherapy is safe and effective for unresectable ATC.
- This combination demonstrates particular benefit in patients with BRAF V600E mutations.
- The findings support this regimen as a valuable first-line treatment option.
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