doi:10.1007/s44178-022-00016-7...
Springer
Medicine & Public Health
2022
11/9/2022
Introduction Locally advanced thyroid cancer refers to thyroid cancer that invades important structures of the neck, with poor prognosis.
Neoadjuvant targeted therapy has the potential to increase the R0/1 resection rate in locally advanced thyroid cancer and improve the outcome in these patients.
Methods We conducted a systematic review of studies that reported neoadjuvant targeted therapy in locally advanced thyroid cancer.
Individual patient data was extracted from eligible studies.
Objective response rate (ORR) and R0/1 resection rate were calculated.
Results Sixteen studies and 32 patients were included into analysis, including 18 differentiated thyroid cancer (DTC), 3 medullary thyroid cancer (MTC), 8 anaplastic thyroid cancer (ATC) and 3 poor-differentiated thyroid cancer (PDTC).
Most patients were stage T4a (53.1%) and T4b (28.1%).
81.3% patients had regional lymph node metastasis and 37.5% had distant metastasis.
RET mutated MTC and BRAF mutated ATC were treated with selective RET inhibitor and selective BRAF/MEK inhibitors.
Other treatment regimens were multitarget tyrosine kinase inhibitors (mTKIs).
The average duration of treatment was 4.3 months (SD = 4.1).
The overall ORR was 78.1% (95%CI: 60.0%–90.7%), and the R0/1 resection rate for the intention to treat population was 78.1% (95%CI: 60.0%–90.7%).
With a median follow-up time of 12.1 months, 1 DTC patient and 3 ATC patients died of the disease.
Conclusions Neoadjuvant targeted therapy was a new treatment option for locally advanced thyroid cancer and might improve the R0/1 resection rate in selective cases.
However, more clinical trials with longer follow-up time are awaited to confirm the clinical benefit of neoadjuvant targeted treatment.
Huang, Nai-si,Wang, Yu,Wei, Wen-jun,Xiang, Jun,Chen, Jia-ying,Guan, Qing,Wang, Yun-jun,Lu, Zhong-wu,Ma, Ben,Hu, Jia-qian,Wang, Yu-long,Ji, Qing-hai, 2022, A systematic review of neoadjuvant targeted therapy in locally advanced thyroid cancer, Springer