Genetic Testing and Research: A Key Focus for Tackling the Most Aggressive Types of Thyroid Cancer
November 15, 2016 | by Travis Marshall
For most people diagnosed with thyroid cancer, treatment is a relatively straightforward combination of surgery and radioactive iodine treatment. According to the American Cancer Society, survival rates for papillary thyroid cancer — the most common form, accounting for 80 percent of cases — is almost 100 percent at Stages 1 and 2, and 93 percent at stage 3.
But that is not always the case. There are other forms of thyroid cancer that can be highly aggressive and challenging to treat. To learn more, we spoke with one of City of Hope's thyroid cancer experts, Behrouz Salehian, M.D., endocrinologist and associate professor in the Department of Clinical Diabetes, Endocrinology & Metabolism.
What are the main areas of focus on thyroid cancer at City of Hope?
Since the majority of thyroid cancer patients receive effective treatment without needing a referral to City of Hope, Salehian explained that he and his colleagues typically see the more complex cases.
They focus primarily on two things:
- Genetic testing to identify new fusion genes - “The patients referred to us are the ones with advanced thyroid cancer that doesn't respond to traditional treatments, so we try to understand these rare forms of the disease better through genetic testing,” Salehian said. “We're working to identify new genetic variations that may respond to specific treatments.”
- Treating highly aggressive and advanced forms of thyroid cancer - Salehian said that anaplastic thyroid carcinoma accounts for only about 2 percent of all thyroid cancers, but almost 50 percent of mortality. “The median survival for these patients is around 3.5 months, so we put a lot of effort into moving quickly with aggressive treatments in these cases,” he said.
What does aggressive treatment for anaplastic thyroid carcinoma entail?
This form of thyroid cancer is devastating because of its rapid progression. “When I first came here, I saw a patient whose tumor progressed into the base of the skull within two weeks,” Salehian said. “So we move very quickly with neck dissection surgery that removes the larynx, trachea and muscle from the neck along with the thyroid gland to try and contain the cancer.” However, patients often relapse. Of the 12 patients who Salehian has seen undergo this procedure, three passed away within one year.
Are there any advances that could improve outcomes for these patients?
Salehian is optimistic that better treatments are on the horizon. “We are working on a multicenter, open-label, phase 2 clinical trial on the effects of a medication called Lenvatinib for patients with anaplastic thyroid carcinoma,” he said. “It has already shown promise as treatment for less aggressive forms of thyroid cancer that can't be effectively treated with surgery. The hope is that it can improve progression-free survival and response rates for patients with anaplastic thyroid carcinoma as well.”
Learn more about our thyroid cancer program. If you are looking for a second opinion or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.
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