The first experience in Russia of applying a tumor differentiation protocol in a patient with progressive, radioiodine-refractory BRAF-positive papillary thyroid cancer. Case report

Journal of Modern Oncology, Год журнала: 2025, Номер 26(4), С. 441 - 446

Опубликована: Фев. 18, 2025

Differentiated thyroid cancer (DTC) has a fairly favorable prognosis and high overall survival (OS). However, approximately 10-15% of patients develop distant metastases, primarily to the lungs. No uptake radioactive iodine 131I during first course therapy (RAI-T) or absence significant response RAI-T can be noted in 20-50% with advanced forms disease, which enables them classified as RAI-T-resistant (RAIR). The for RAIR is less favorable, 5-year OS 50%, compared 10-year up 98% nonaggressive DTC. Currently, multikinase inhibitors, mainly targeting vascular endothelial growth factor receptors, are standard treatment these patients. recent studies suggest that tumor cells restore ability presence mutation BRAF V600E gene following prior BRAF-/MEK inhibitors (tumor redifferentiation). article presents case 56-year-old patient diagnosed papillary cancer. During observation, disease progression was due metastases lungs after two courses total activity 9.3 GBq, confirming RAIR. Molecular genetic study primary tissue block revealed gene. An oncological team board held at National Medical Research Center Endocrinology, offered targeted inhibitors. After 6 weeks therapy, diagnostic whole-body scintigraphy showed increased lungs, prompting repeated high-dose an 7.5 GBq. Six months treatment, radiological improvement observed: partial reduction size metastatic lung lesions by 40% time data publication. continued severe adverse events. Thus, combined RIT considered option This strategy potentially significantly improve both quality life aggressive

Язык: Английский

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Artificial intelligence in tumor drug resistance: Mechanisms and treatment prospects

Опубликована: Фев. 1, 2025

Язык: Английский

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Comprehensive Gene Expression Analysis in Papillary Thyroid Carcinoma Reveals a Transcriptional Profile Associated with Reduced Radioiodine Avidity

Endocrine Pathology, Год журнала: 2025, Номер 36(1)

Опубликована: Фев. 21, 2025

Язык: Английский

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Interactions Between Radiotherapy Resistance Mechanisms and the Tumor Microenvironment

Critical Reviews in Oncology/Hematology, Год журнала: 2025, Номер unknown, С. 104705 - 104705

Опубликована: Март 1, 2025

Язык: Английский

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Advances in Diagnosis and Treatment of Radioactive Iodine Refractory Differentiated Thyroid Cancer

IntechOpen eBooks, Год журнала: 2025, Номер unknown

Опубликована: Март 28, 2025

Differentiated thyroid cancer (DTC) often has a good prognosis, but some patients have progressive disease after radioiodine-131 (131I) treatment and become radioactive iodine refractory differentiated (RAIR-DTC). At present, the concept of precision diagnosis based on molecular characteristics gradually been known, variety targeted drugs demonstrated efficacy safety. Multi-kinase inhibitors selective kinase significantly prolong progression-free survival overall time RAIR-DTC patients. Local is beneficial for relieving local symptoms reducing tumor burden. This chapter will introduce recent advances in mechanism, diagnosis, RAIR-DTC.

Язык: Английский

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Identification of thyroid cancer biomarkers using WGCNA and machine learning

European journal of medical research, Год журнала: 2025, Номер 30(1)

Опубликована: Апрель 5, 2025

Язык: Английский

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Predictive biomarkers in thyroid cancer in the current molecular-morphology paradigm

Surgical and Experimental Pathology, Год журнала: 2024, Номер 7(1)

Опубликована: Авг. 14, 2024

Abstract Thyroid cancer is one of the most common types worldwide. It a spectrum different diseases, ranging from very indolent to lethal tumors. Differentiated Carcinoma (DTC), thyroid malignancy, has often an excellent prognosis, but some patients develop metastatic Radioiodine-Refractory disease (RAIR) that cannot be controlled locally. In this setting, and for with Medullary (MTC) Anaplastic (ATC), systemic treatment non-selective Multikinase Inhibitors (MKIs) employed improve survival rates quality life. The molecular characterization showed main drivers carcinogenesis not only correlate morphological clinical features can targeted by modern highly selective Kinase Inhibitors: vemurafenib dabrafenib carcinomas BRAF V600E mutation, including Papillary (PTC) its subtypes; in association MEK1/2 inhibitor trametinib V600E-mutant ATC; larotrectinib entrectinib NTRK fusions selpercatinib pralsetinib MTC RET point mutations DTC -fusions. Apart those markers, Microsatellite Instability status (MSI), Tumor Mutation Burden (TMB) PD1/PD-L1 assessment have been explored tumors, although immunotherapy ATC shown modest results. Herein, we present comprehensive review relevant markers predictive value pathology.

Язык: Английский

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TERT promoter mutations contribute to adverse clinical outcomes and poor prognosis in radioiodine refractory differentiated thyroid cancer

Scientific Reports, Год журнала: 2024, Номер 14(1)

Опубликована: Окт. 10, 2024

Telomerase reverse transcriptase promoter (TERTp) mutations are associated with non-radioiodine avidity. However, the role of these in clinical outcomes patients radioiodine-refractory differentiated thyroid cancer (RAIR-DTC) remains unknown. Herein, we aim to analyze gene and manifestations verify TERTp's driving disease progression RAIR-DTC outcomes. Next-generation sequencing data were obtained from 243 DTC. Of 25 TERTp mutations, 80% (20/25) had RAIR-DTC. was significantly less prevalent BRAF

Язык: Английский

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Pathogenesis and Management Strategies in Radioiodine-Refractory Differentiated Thyroid Cancer: From Molecular Mechanisms Toward Therapeutic Approaches: A Comprehensive Review

Journal of Clinical Medicine, Год журнала: 2024, Номер 13(23), С. 7161 - 7161

Опубликована: Ноя. 26, 2024

Thyroid cancer (TC) remains the most common in endocrinology. Differentiated thyroid (DTC), type of TC, generally has a favorable outlook with conventional treatment, which typically includes surgery along radioiodine (RAI) therapy and thyroid-stimulating hormone (TSH) suppression through therapy. However, small subset patients (less than 5%) develop resistance to RAI. This occurs due loss Na/I symporter (NIS) activity, is crucial for iodine absorption cells. The decline NIS activity appears be gene modifications, reconfigurations irregular stimulation signaling pathways such as MAPK PI3K/Akt pathways. These molecular changes lead diminished ability DTC cells concentrate iodine, makes RAI ineffective. As consequence, radioiodine-refractory require alternative treatments. Therapy tyrosine kinase inhibitors (TKIs) emerged primary treatment option inhibit proliferation growth RAIR-DTC, targeting responsible tumor progression. In this article, we analyze processes explore both emerging therapeutic strategies managing aiming improve patient outcomes.

Язык: Английский

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DPP4 Promotes Papillary Thyroid Cancer Progression by Regulating the Infiltration and Exhaustion of CD8+ T cells

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Май 30, 2024

Background: Papillary thyroid cancer (PTC) is one of the most prevalent endocrine malignancy with a rapidly increasing incidence worldwide, special immune microenvironment which not well characterized. Thus, aim this study was to identify key biomarkers that regulate cells for development and recurrence PTC. Methods: The expression immune-associated differentially expressed genes (DEGs) in human PTC examined by bioinformatics analysis TCGA GEO datasets. The CIBERSORT TIMER tool used analyze distribution tumor[1]infiltrating Furthermore, DEG function infiltration CD8+ T were explored using specimens. Results: In study, we identified DPP4 as gene differential among four datasets dataset validated its overexpression profile data from TCGA, HPA databases, WB PCR analysis. upregulation significantly correlated advanced grades, stages, poor progression-free survival.Based on analysis, tightly diverse cell types, especially subtypes. Compared benign tumor, proportion CD3+CD8+ peripheral blood patients decreased, while CD3+CD8+DPP4+ increased. relative PD-L1 CTLA-4 CD8+DPP4+ higher than CD8+DPP4- cells. addition, showed lower IFN-γ increased IL-13 tumor. IFN-γ, TNF-α, IL-4, IL-5, both tumor patients. Conclusion: Our work suggests upregulated tissues clinical stages outcomes regulates infiltration, but particular involves evasion exhaustion. These findings may offer new prospect targeting exhaustion therapies treatment

Язык: Английский

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