Redifferentiating Effect of Larotrectinib in NTRK -Rearranged Advanced Radioactive-Iodine Refractory Thyroid Cancer.
Lionel GroussinHélène TheodonLaura BessieneLeopoldine BricaireFidéline Bonnet-SerranoBéatrix Cochand-PriolletKaren LeroySimon GarinetEric PasmantJérémie ZerbitRomain SebanFrançois GoldwasserJérôme ClercAnne Segolene CottereauOlivier HuillardPublished in: Thyroid : official journal of the American Thyroid Association (2022)
Metastatic thyroid cancers may dedifferentiate and become radioactive-iodine (RAI) resistant. A redifferentiating effect can be observed with inhibitors of the mitogen-activated protein kinase pathway in thyroid cancers with point mutation in oncogenes. This effect allows RAI reuptake that may lead to a therapeutic effect different from the antitumoral effect of the inhibitor. The potential redifferentiating effect of inhibitors targeting oncogenic fusion-genes was suggested by one adult and one pediatric patient using larotrectinib in NTRK -rearranged tumors. We report on three consecutive adult patients with metastatic RAI-resistant NTRK- rearranged thyroid cancer who received larotrectinib for disease progression and for whom the redifferentiating effect was examined. Larotrectinib-induced RAI reuptake in all or part of the metastatic disease for two patients and no reuptake was noted for the other patient. We demonstrate that redifferentiation of NTRK -rearranged RAI-resistant thyroid cancer with larotrectinib may exist but does not occur in all patients.
Keyphrases
- end stage renal disease
- newly diagnosed
- ejection fraction
- small cell lung cancer
- peritoneal dialysis
- prognostic factors
- risk assessment
- magnetic resonance
- case report
- oxidative stress
- transcription factor
- patient reported outcomes
- high glucose
- tyrosine kinase
- climate change
- protein kinase
- genome wide identification