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Add-on radioiodine during long-term BRAF/MEK inhibition in patients with RAI-refractory thyroid cancers: a reasonable option?

Filipe Miguel Montes de JesusVittoria EspeliGaetano PaoneLuca M Giovanella
Published in: Endocrine (2023)
Dual modulation of the MAPK pathway with BRAF (e.g., dabrafenib) and MEK (e.g., trametinib) inhibitors has the potential to re-establish radioiodine (RAI) sensitivity in BRAF-mutated RAI-refractory (RAI-R)-differentiated thyroid carcinoma (DTC) cells. Here we showed that (1) double BRAF/MEK inhibition may still reach a significant redifferentiation in patients with a long-history RAI-R DTC and multiple previous treatments; (2) the addition of high RAI activities may obtain a significant structural response in such patients; and (3) a divergence between increasing thyroglobulin and structural response may be a reliable biomarker or redifferentiation. Accordingly, the add-on prescription of high activities of 131I should be considered in RAI-R patients under multikinase inhibitors with stable or responding structural disease and divergent increase of Tg levels.
Keyphrases
  • end stage renal disease
  • chronic kidney disease
  • newly diagnosed
  • ejection fraction
  • prognostic factors
  • pi k akt
  • signaling pathway
  • wild type
  • patient reported outcomes
  • oxidative stress
  • risk assessment