ESMO Congress 2019: Quick Takes From Key Clinical Trials
The ESMO Congress continues to grow as a pivotal platform for research in clinical oncology. At the ESMO Congress 2019, important findings were showcased in more than 2,200 studies, including 93 late-breaking abstracts. The ASCO Post summarized much of that news in separate articles over several...
2019 Annual Meeting of the American Thyroid Association Briefs
The American Thyroid Association held its 2019 Annual Meeting from October 30 to November 3 in Chicago. Below are brief summaries of important oral presentations on thyroid cancer from the meeting. Incidence and Incidence-Based Mortality in a State Results of a retrospective analysis of thyroid...
ESMO 2019: LIBRETTO-001 Trial of Selpercatinib in RET Fusion–Positive Thyroid Cancer
Patients with advanced RET fusion–positive thyroid cancer and RET-mutant medullary thyroid cancer had high rates of response following treatment with selpercatinib, according to findings from the phase I/II LIBRETTO-001 trial presented by Wirth et al at the European Society for Medical Oncology...
For Maria Papaleontiou, MD, Research Holds the Key to Improving Care of Patients With Thyroid Cancer
Maria Papaleontiou, MD, whose research interests focus on the complex issues surrounding the management of thyroid cancer and thyroid disease in general, was born on Cyprus, a small island nestled in the azure waters of the Mediterranean Sea. She recently spoke with The ASCO Post about her life and ...
Lauren P. Wallner, PhD, MPH, on Thyroid Cancer: Reducing Overtreatment With Radioactive Iodine
Lauren P. Wallner, PhD, MPH, of the University of Michigan, discusses her findings from a population-based study, which showed that many patients believe they had no choice about whether or not to receive radioactive iodine, even though it often does not improve survival. There is a need, she says, for better shared decision-making (Abstract 159).
News From JCO and JOP
STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology (JCO) and the Journal of Oncology Practice (JOP). Future installments...
The Rising Incidence of Thyroid Cancer Reconsidered
Despite a significant rise in the incidence of thyroid cancer, the U.S. Preventive Services Task Force (USPSTF), a panel of independent experts in primary care and screening, has given thyroid cancer screening a D recommendation, which is a recommendation against screening. To shed light on this...
Bridging the Survivorship Care Gap for Young Adult Survivors of Thyroid Cancer
Although thyroid cancer is among the five most common carcinomas diagnosed in adolescents and young adults (AYAs) between the ages of 15 and 39—thyroid cancer is more common in young women than young men and is the most common cancer diagnosed in females between the ages of 15 and 29 and the second ...
U.S. Preventive Services Task Force Recommends Against Screening for Thyroid Cancer in Asymptomatic Individuals
AS REPORTED in JAMA, the U.S. Preventive Services Task Force (USPSTF) has recommended against thyroid cancer screening in asymptomatic individuals.1 The current USPSTF statement is an update of a 1996 USPSTF recommendation statement. The recommendation was based on Task Force review of evidence on ...
Are Thyroid Cancer Incidence and Mortality Rates Truly Increasing in the United States?
THYROID CANCER diagnoses are increasing at a rate faster than any other malignancy in the United States. In 2017, there will be 56,870 new cases, accounting for 3.4% of all cancers, and 2,010 people will die of thyroid cancer.1 This represents a more than 200% increase in incidence since the...
Trends in Thyroid Cancer Incidence and Mortality in the United States
THE REPORTED INCIDENCE of thyroid cancer has markedly increased in the United States in recent decades, largely reflecting an increase in reported rates of papillary thyroid cancer. It has been unclear whether the increase in incidence is reflected in mortality rates over time. In a study of...
Dong Wook Shin, MD, DrPH, MBA, on Thyroid Cancer: Risk of Side Effects
Dong Wook Shin, MD, DrPH, MBA, of Seoul National University Cancer Hospital, discusses the risk of coronary heart disease and ischemic stroke in patients with thyroid cancer taking levothyroxine (Abstract 105).
I’ve Survived Two Cancers
In 2012, my husband, Robert, and I were looking forward to starting the next phase of our lives and were feeling excited about the future. Although only in our 50s, we had decided to retire early from our full-time careers, move to our cabin in Hayward, Wisconsin, and find less stressful part-time ...
FDA Grants Selumetinib Orphan Drug Designation for Adjuvant Treatment of Differentiated Thyroid Cancer
Earlier this month, AstraZeneca announced that the U.S. Food and Drug Administration (FDA) has granted Orphan Drug designation for the investigational MEK1/2 inhibitor selumetinib for adjuvant treatment of patients with stage III or IV differentiated thyroid cancer. Selumetinib inhibits the MEK...
Raising Awareness of Medullary Thyroid Carcinoma
I’m used to having bumps and cysts pop up on my body, so when I felt a lump on the front of my throat, just below my Adam’s apple, I brushed it off. But when it was still there 6 months later, I became concerned and decided to see an ear, nose, and throat specialist. He performed a fine-needle...
Detection of Thyroid Cancer Most Cost-Effective With Physical Examination, Not Ultrasound Screening
A study evaluating annual physical examination as a screening method to detect thyroid cancer in cancer survivors exposed to neck radiation has shown a substantial cost reduction compared with ultrasound screening, with no thyroid cancer–related mortality.1 According to the analysis, this method...
Dana Barnea, MD, on Screening Survivors for Thyroid Cancer
Dana Barnea, MD, of Memorial Sloan Kettering Cancer Center, discusses data that suggest annual palpation of the thyroid is an adequate and safe means of screening childhood and young adult cancer survivors, a population at high risk for this type of cancer (Abstract 254).
Wide Variation in Use of Radioactive Iodine for Thyroid Cancer
The proportion of patients with well-differentiated thyroid cancer who received radioactive iodine following total thyroidectomy increased significantly since 1990, and there is wide variation in the use of adjuvant radioactive iodine, according to a study in the Journal of the American Medical...
Oncology Research a Strong Presence at the American College of Surgeons Meeting: New Data in Pancreatic, Rectal, Thyroid, and Breast Cancers
Research in cancer staging, surgical procedures, outcomes, and medical treatment was included among the 2,000 abstracts presented at the 97th Annual American College of Surgeons Clinical Congress in San Francisco. The ASCO Post was there to capture the latest findings. Neoadjuvant Chemotherapy in...
Vandetanib Demonstrates Therapeutic Efficacy in Patients with Advanced Medullary Thyroid Cancer
A phase III trial among patients with locally advanced or metastatic medullary thyroid cancer met its primary objective of progression-free survival prolongation among patients receiving vandetanib compared to placebo. The secondary efficacy endpoints of objective response rate, disease control...
Vandetanib: New Drug for Unresectable Medullary Thyroid Cancer
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication The oral kinase inhibitor vandetanib (Caprelsa) was...
Low-dose Radioiodine as Effective as High-dose in Thyroid Ablation
Two studies in The New England Journal of Medicine found that low-dose radioiodine is as effective as a high-dose strategy in treating patients with thyroid cancer and that recombinant human thyrotropin (thyrotropin alfa [Thyrogen]) and thyroid hormone withdrawal had similar efficacy in preparing...
Obese Patients at Higher Risk of Aggressive Thyroid Tumors
Obese patients present with more advanced and more aggressive forms of papillary thyroid cancer and should be screened for thyroid cancer with sonography, which is more sensitive in detecting thyroid cancer than physical examination alone, according to a study published online in the Archives of...
Cabozantinib Prolongs Progression-free Survival in Advanced Medullary Thyroid Cancer
Cabozantinib prolonged progression-free survival in patients with unresectable, locally advanced, or metastatic medullary thyroid cancer with documented disease progression in the phase III EXAM trial. Based on these results, Exelixis submitted a New Drug Application to the FDA in May 2012. The...
Molecularly Targeted Treatment of Thyroid Cancer Rapidly Evolving
Recent advances in understanding the pathogenesis and altered signaling pathways in thyroid cancer are improving treatment options for this malignancy, especially for the subset of patients with medullary thyroid cancer and those with differentiated thyroid cancer that has metastasized, according...
Differentiated Thyroid Cancer: Who, When, and How to Treat?
Differentiated thyroid cancer—papillary, follicular, and Hürthle cell carcinomas—has historically been managed by endocrinologists, surgeons, and radiation oncologists, but recent progress in the field has led to greater involvement by medical oncologists, especially in the care of patients with...
Cabozantinib Approved for Treatment of Progressive Metastatic Medullary Thyroid Cancer
The FDA recently approved cabozantinib (Cometriq), for the treatment of patients with progressive metastatic medullary thyroid cancer. Cabozantinib is a small molecule that inhibits the activity of multiple tyrosine kinases, including RET, MET, and VEGF receptor 2. The approval was based on the...
Cabozantinib in Metastatic Medullary Thyroid Cancer
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication On November 29, 2012, cabozantinib (Cometriq) was...
Sorafenib Halts Disease Progression in Metastatic Differentiated Thyroid Cancer
For the first time in decades, a drug has halted disease progression in treatment-resistant differentiated thyroid cancer, according to the results of a phase III study presented at the 2013 ASCO Annual Meeting.1 No new drugs have been approved for differentiated thyroid cancer in 40 years, but...
More Prudent Interpretation of Thyroid Ultrasound Could Reduce Unnecessary Biopsies
Thyroid ultrasound imaging could be used to identify patients who have a low risk of thyroid cancer for whom biopsy could be deferred, according to a retrospective case-control study reported in JAMA Internal Medicine. Reviewing 11,618 thyroid ultrasound imaging examinations from 8,806 patients...
Sorafenib Granted Priority Review for Differentiated Thyroid Cancer
Bayer HealthCare and Onyx Pharmaceuticals recently announced that the FDA has granted priority review designation to the supplemental new drug application of sorafenib (Nexavar) tablets for the treatment of locally advanced or metastatic radioactive iodine-refractory differentiated thyroid cancer....
High-Tech Imaging Contributes to Overdiagnosis, Overtreatment of Low-Risk Thyroid Cancers
A study from the Mayo Clinic Center for the Science of Health Care Delivery finds that advances in imaging technologies, including ultrasound, computed tomography, and magnetic resonance imaging, are fueling an epidemic in the diagnosis and treatment of thyroid cancers that are unlikely to ever...
Cabozantinib in Medullary Thyroid Cancer: A Landscape-Shaping New Treatment
Medullary thyroid cancer is derived from parafollicular C cells in the thyroid gland. The disease is sporadic in about 75% of cases and hereditary in the remaining 25%.1 Oncogenic mutations in the gene for tyrosine kinase receptor rearranged during transfection (RET) are driver genetic alterations...
Cabozantinib Improves Disease-Free Survival in Progressive Medullary Thyroid Cancer
Cabozantinib (Cometriq) is an inhibitor of hepatocyte growth factor receptor (MET), vascular endothelial growth factor receptor 2 (VEGFR2), and rearranged during transfection (RET) tyrosine kinases. In a phase III trial reported in Journal of Clinical Oncology, Rossella Elisei, MD, of University of ...
FDA Approves Sorafenib to Treat Late-Stage Differentiated Thyroid Cancer
The U.S. Food and Drug Administration recently expanded the approved uses of sorafenib (Nexavar) to treat late-stage differentiated thyroid cancer. The new indication is for patients with locally recurrent or metastatic, progressive differentiated thyroid cancer that no longer responds to...
Sorafenib in Differentiated Thyroid Carcinoma
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. New Indication On November 22, 2013, sorafenib (Nexavar) was...
‘Epidemic of Diagnosis’ of Thyroid Cancer Is Most Acute for Women
The epidemiology of the increased incidence of thyroid cancer, which has nearly tripled since 1975, “suggests that it is not an epidemic of disease but rather an epidemic of diagnosis,” Louise Davies, MD, MS, and H. Gilbert Welch, MD, MPH, concluded after analyzing trends in patients diagnosed with ...
Thyroid Cancer On the Rise: Is It Clinically Meaningful?
According to data from the Surveillance, Epidemiology, and End Results (SEER) program, rates for new cases of thyroid cancer in the United States have been rising on average 6.4% each year over the past 10 years, and death rates have been rising on average 0.9% each year over the same period. The...
Increased Incidence of Thyroid Cancer: An Epidemic of Diagnosis?
In a study reported in JAMA Otolaryngology Head & Neck Surgery,1 Davies and Welch found that the incidence of thyroid cancer has nearly tripled since 1975. However, the increase appears to represent an “epidemic of diagnosis” and to almost exclusively represent increased diagnosis of papillary...
Progress in Differentiated Thyroid Cancer
Treatment of differentiated thyroid cancer has been slow to advance. Three decades lapsed between the description of the first differentiated thyroid cancer patient being cured by radioactive iodine in the 1940s1 and the report of the study that led to the approval of doxorubicin in the 1970s.2 The ...
Sorafenib Improves Progression-Free Survival in Progressive Radioactive Iodine–Refractory Differentiated Thyroid Cancer
Patients with radioactive iodine–refractory locally advanced or metastatic differentiated thyroid cancer have a poor prognosis. In the double-blind phase III DECISION trial reported in The Lancet, Marcia S. Brose, MD, PhD, of Abramson Cancer Center of the University of Pennsylvania, and colleagues ...
Impressive Delay in Thyroid Cancer Progression Achieved With Lenvatinib
The investigational tyrosine kinase inhibitor lenvatinib reduced disease progression by 79%, as compared to placebo, in patients with metastatic differentiated thyroid cancer that is refractory to radioactive iodine in the phase III SELECT trial. These findings were presented at the 2014 ASCO...
Lenvatinib Receives Priority Review Designation for Advanced Thyroid Cancer
The U.S. Food and Drug Administration (FDA) has given Priority Review designation to the New Drug Application for lenvatinib mesylate as a treatment for progressive radioactive iodine–refractory differentiated thyroid cancer. Lenvatinib is an oral multiple receptor tyrosine kinase inhibitor with a...
South Korean Study Sparks Warnings About the Hazards of Overscreening
An “epidemic of diagnosis” of thyroid cancer is occurring in South Korea and “absolutely could happen here,” according to H. Gilbert Welch, MD, MPH, Professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire. Dr. Welch is coauthor of an article...
FDA Approves Lenvatinib for Progressive Radioiodine-Refractory Differentiated Thyroid Cancer
The U.S. Food and Drug Administration (FDA) has granted approval to lenvatinib (Lenvima) to treat patients with progressive, differentiated thyroid cancer whose disease progressed despite receiving radioactive iodine therapy. Lenvatinib is a tyrosine kinase inhibitor that binds to multiple sites...
Lenvatinib in Advanced Radioiodine-Refractory Differentiated Thyroid Cancer
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On February 13, 2015, lenvatinib (Lenvima) was approved for the...
New Analysis Reports Increased Risk of Thyroid Cancer After Breast Cancer Diagnosis
Breast cancer survivors are at increased risk of developing thyroid cancer, especially within 5 years of their breast cancer diagnosis, according to a new analysis of a large national database. The study results were presented at the Endocrine Society’s 97th Annual Meeting.1 “Recognition of this...
Welcome to Multikinase Inhibitors in Radioiodine-Refractory Thyroid Cancer
In the past 2 decades, the incidence of thyroid cancer has risen steeply, with rates now growing by 5.5% annually.1 In 2014, 62,980 new cases of thyroid cancer were diagnosed in the United States. The good news is that, overall, the prognosis of thyroid cancer remains excellent; 97.8% of patients...
Large Improvement in Progression-Free Survival With Lenvatinib in Radioiodine-Refractory Thyroid Cancer
In a phase III trial reported in The New England Journal of Medicine, Martin Schlumberger, MD, of Institut Gustave Roussy, and colleagues found that the multikinase inhibitor lenvatinib (Lenvima) produced a large improvement in progression-free survival vs placebo in patients with advanced...
Cancer Will Always Be Part of My Life
My first experience with cancer was when I was just 9 years old, and a lump the size of an egg popped out on the right side of my neck. A biopsy of the tumor found that it was Hodgkin lymphoma, and I was given huge doses of external-beam radiotherapy applied to my neck, chest, and underarm lymph...
