Does Molecular Genotype Provide Useful Information in the Management of Radioiodine Refractory Thyroid Cancers? Results of a Retrospective Study.

摘要: Whether mutation status should be used to guide therapy is an important issue in many cancers. We correlated profile radioiodine-refractory (RAIR) metastatic thyroid cancers (TCs) with patient outcome and response tyrosine kinase inhibitors (TKIs), discussed the results other published data. Outcome 82 consecutive patients RAIR carcinoma prospectively tested for BRAF, RAS PI3KCA mutations was retrospectively analyzed, including 55 treated multikinase inhibitors. Papillary carcinomas (PTCs) were most frequent histological subtype (54.9 %), followed by poorly differentiated [PDTC] (30.5 %) follicular [FTC] (14.6 %). A genetic identified 23 (28 %) BRAF frequently mutated gene (23 %). Median progression-free survival (PFS) on first-line TKI treatment 14.6 months (95% CI 9.9–18.4). positively influenced median PFS, both entire TKI-treated cohort (median PFS 34.7 months versus 11.6 months; hazard ratio [HR] 0.29; 95% 0.09–0.98; p = 0.03) PTC (n = 22) [log-rank p = 0.086; HR 2.95; 95 % 0.81–10.70). However, patients, PDTC histologic only independent prognostic factor multivariate analysis (HR 2.36; 1.01–5.54; p = 0.048). Patients BRAF-mutant had a significantly longer than wild-type when TKIs. due small number of further investigations are required, especially understand potential positive effect TC while having negative impact RAI-sensitive patients.