ASCO Abstract # 5591
Aggressive treatment of anaplastic thyroid carcinoma has dramatically increased survival in the small group of patients who chose to undergo it, say physicians at Mayo Clinic. Their findings will be presented at the annual meeting of the American Society of Clinical Oncology, to be held June 4-8 in Chicago.
Mayo oncologists say this new approach reflects the need to aggressively treat metastasis even when this rare cancer seems to be confined to the neck. Historically, anaplastic thyroid cancer has been treated with surgery and radiation, but due to rapid spread of microscopic cancer, only between 10 and 20 percent of patients survive past a year. Because the prognosis for this cancer is so poor, Mayo physicians felt that a more aggressive pilot approach that added in chemotherapy early on was merited.
Of 24 patients with newly diagnosed anaplastic thyroid cancer seen at Mayo Clinic between 2003 and 2007, 10 patients with local disease elected to pursue the aggressive approach. After surgery, the patients were treated with intensity modulated radiation therapy (IMRT), a more tailored form of radiation therapy than has been used before, and with aggressive chemotherapy (docetaxel and doxorubicin) in efforts to simultaneously control disease in the neck and forestall metastasis.
One-year survival in this group was 70 percent, with six of the 10 patients (60 percent) alive at least two years post-treatment — five of them without evidence of disease. Two of these patients were treated more than three years ago and are still in remission.
“The results are far superior to what we have seen before or even expected were possible,” says Keith Bible, M.D., Ph.D., a lead investigator of the study, along with Robert Foote, M.D., and Julian Molina, M.D., Ph.D.
However, the benefits come at the cost of toxicity, the researchers add.
“Toxicity is a very real issue, to the point that many patients required hospitalization related to side effects from the therapy, but no deaths resulted from therapy,” says Dr. Bible, who is presenting the results. Of the four patients who have died to date, all succumbed to their disease, not to treatment effects.
Dr. Bible added that a clinical trial formally testing two approaches to the addition of chemotherapy to radiotherapy in a randomized fashion will be launched in the fall and will include other centers nationwide. The new study will use a related chemotherapy drug, paclitaxel, as well as the addition of a targeted therapy. Dr. Bible will co-lead the study along with Eric Sherman, M.D., from Memorial Sloan-Kettering Cancer Center and others.
Mayo Clinic is regarded as a center of excellence for the treatment of anaplastic thyroid cancer due to the clinic’s specialization in thyroid and endocrine cancers — an expertise that dates back to the practice of thyroid surgeon Charles H. Mayo, M.D., one of the founders of Mayo Clinic. “We have become seriously focused on how to treat these and other rare endocrine cancers more effectively,” Dr. Bible says.
Below is a link to an edited youtube video with Dr. Bible.
I’m a thyroid cancer survivor. I have none left. If after two injections of thyrogen and a radio active iodine you feel the best ever, is that an indication of low iodine? I have not cooked with salt since 1995.
I am so happy you were able to beat this disease Linda!
My mother, aged 59, died in March 2011 of Anaplastic Thyroid Cancer, just 6 months after diagnosis (September 2010). Although she underwent radiation therapy at the Mayo Clinic and various chemo drugs (Cisplatin & Gemzar, Carboplatin & Taxol) and other drugs (Nexavar), all were unsuccessful at slowing down the spread of the disease (though Cisplatin showed to be the most effective of the drugs tried). Indeed, “the need to aggressively treat metastasis even when this rare cancer seems to be confined to the neck” is key; unfortunately the rarity of this disease–and consequently the lack of awareness–can lead to misdiagnosis (as was the case for my mom) by primary care physicians. With diseases such as ATC–where time is of the essence–misdiagnosis delays immediate treatment, perhaps the only hope for survival. While there is no known cause of ATC, studies suggest that exposure to radiation (e.g., through dental X-rays, mammographies) causes this extremely lethal cancer. ALWAYS ***ASK*** FOR A THYROID GUARD before undergoing these procedures (nurses/doctors will most likely not offer it without prompting from the patient). Dr. Oz recently aired a show on the fastest growing cancer in women–thyroid cancer–and also highly advocated the use of a thyroid guard. Awareness is so crucial. A year ago today I would have never believed what would be in store for my family in just a 6-month timeframe. I watched my mother suffer tremendously before she succumbed to her disease.
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