Please wait a minute...
93TMR Cancer  2019, Vol. 2 Issue (3): 222-226    DOI: 10.12032/TMRC201800057
Cancer Biology     
Treatment of undifferentiated thyroid carcinoma with darafini and trametinib:a case report and literature review
Nan Nan1, Tao Chi1, Xiao-Juan Yan1,*()
1. Department of Oncology, Taiyuan Traditional Chinese Medicine Hospital, Shanxi 030009, China.
Download: HTML     PDF(401KB)
Export: BibTeX | EndNote (RIS)      

Highlights

The treatment of undifferentiated thyroid cancer is still a problem to be explored.

Combination therapy with drugs may be a new strategy for the treatment of undifferentiated thyroid cancer.

Comments

Many patients with undifferentiated thyroid cancer have no significant response to treatment, which is an important cause of tumor progression and death in patients. Genetic testing and the use of targeted drugs against mutant genes may be a viable approach to the treatment of undifferentiated thyroid cancer.

Abstract

Undifferentiated thyroid carcinoma progresses rapidly and has a poor prognosis. The median progression-free survival is only about half a year, and the effect of conventional radiotherapy and chemotherapy is poor. Some patients may be associated with BRAF V600E mutation. Dabrafenib and trametinib were approved by the FDA for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations. The combination of the two may make patients receive a better benefit. A phase III clinical trial showed that in patients with advanced malignant melanoma with positive BRAF-V600E mutations, the combination of dabrafenib and trametinib can effectively improve progression-free survival and overall survival in patients.This article describes a case describing a patient with BRAF V600E-mutated thyroid undifferentiated carcinoma that was treated with darafini and trimetinib, and the relevant literature on the combination of the two drugs was analyzed.



Key wordsUndifferentiated thyroid carcinoma      Darafini      Trimetinib      BRAF mutation     
Received: 20 May 2019      Published: 02 September 2019
Corresponding Authors: Yan Xiao-Juan   
E-mail: 708860791@qq.com
Service
E-mail this article
Add to my bookshelf
Add to citation manager
E-mail Alert
RSS
Articles by authors
Nan Nan
Tao Chi
Xiao-Juan Yan
Related Articles
No related articles found!
Cite this article:

Nan Nan , Tao Chi , Xiao-Juan Yan . Treatment of undifferentiated thyroid carcinoma with darafini and trametinib:a case report and literature review. 93TMR Cancer, 2019, 2(3): 222-226. doi: 10.12032/TMRC201800057

URL:

https://www.tmrjournals.com/cancer/EN/10.12032/TMRC201800057     OR     https://www.tmrjournals.com/cancer/EN/Y2019/V2/I3/222

Figure 1 Patient's imaging image
1.   Zhang ZM, Xu ZG, Tang PZ, et al. Re-recognizing undifferentiated thyroid cancer. J Chin Academy Med Sci2006, 28: 323-324.
2.   Amin MB, Edge SB, Greene FL, et al. AJCC Cancer Staging Manual. 8th edit. New York: Springer 2017: 878-883.
3.   Liu Y, Zhang SL.Advances in targeted drugs for thyroid undifferentiated carcinoma. J SurgTheory Prac2018, 23: 169-172.
4.   Vivek S, Robert JK, Zev AW, et al.Dabrafenib and trametinib treatment in patients with locally advanced or metastatic BRAF V600-mutant anaplastic thyroid cancer. J ClinOncol2018, 36: 7-13.
5.   PratilasCA, Solit DB. Targeting the mitogen-activated protein kinase pathway: physiological feedback and drug response. Clin Cancer Res 2010, 16: 3329-3334.
6.   Wan PT, Gamer MJ, Rose SM, et al. Mechanism of activation of the RAF-ERK signaling pathway by oncogenic mutation of B-RAF. Cell2004, 116: 855-867.
7.   He YZ, Jiang Y, Yu JC, et al. Research progress on the relationship between BRAF gene and thyroid cancer. Chin J Surgery 2016, 54: 237-240.
8.   Kurata K, Onoda N, Noda S, et al. Growth arrest by activated BRAF and MEK inhibition in human anaplastic thyroid cancer cells. Int J Oncol 2016, 49: 2303-2308.
9.   McFadden DG, Vernon A, Santiago PM, et al.P53 constrains progression to anaplastic thyroid carcinoma in a Braf-mutant mouse model of papillary thyroid cancer.Proc Natl AcadSci USA 2014, 111: E1600-E1609.
10.   Bavle A, Jones J, Lin FY, et al. Dramatic clinical and radiographic response to BRAF inhibition in a patient with progressive disseminated optic pathway glioma refractory to MEK inhibition. PediatrHematolOncol 2017, 34:254-259.
11.   Grimaldi AM, Simeone E, AsciertoPA. The role of MEK inhibitors in the treatment of metastatic melanoma. CurrOpinOncol 2014, 26: 196-203.
12.   Long GV, Hauschild A, Santanami M, et al. Adjuvant Dabrafenib plus Trametinib in stage III BRAF-Mutated Melanoma. NewEngl J Med 2017, 377: 1813-1823.
13.   Long GV, Stroyakovskiy D, Gogas H, et al. Combined BRAF and MEK inhibition versus BRAF inhibition alone in melanoma. NewEngl J Med 2014, 371: 1877-1888.
14.   Long GV, Flaherty KT, Stroyakovskiy D, et al. Dabrafenib plus trametinib versus dabrafenib monotherapy in patients with metastatic BRAF V600E/K-mutant melanoma: long-term survival and safety analysis of a phase 3 study. Ann Oncol 2017, 28:1631-1639.
15.   Jiang X, Zhou J, Giobbie-Hurder A, et al. The activation of MAPK in melanoma cells resistant to BRAF inhibition promotes PD-L1 expression that is reversible by MEK and PI3K inhibition. Clin Cancer Res 2013, 19: 598-609.
16.   Lavinqia V, Fakih M.Impressive response to dual BRAF and MEK inhibition in patients with BRAF mutant intrahepatic cholangiocarcinoma-2 case reports and a brief review.J Gastrointest Oncol 2016, 7: 98-102 .
17.   Rivalland G, Mitchell P.Combined BRAF and MEK inhibition in BRAF-mutant NSCLC. Lancet Oncol 2016, 17: 860-862.
18.   Planchard D, Besse B, Groen HJM, et al.Dabrafenib plus trametinib in patients with previously treated BRAF (V600E) -mutant metastatic non-small cell lung cancer: an open-label, multicentrephase 2 trial. Lancet Oncol 2016, 17: 984-993.
19.   Sundaram VR, Abbas T.Cardiac tamponade induced by dabrafenib and trametinib combination therapy for melanoma: a case report. Med 2018, 97: e12751.
20.   Dossett LA, Kudchadkar RR, Zager JS.BRAF and MEK inhibition in melanoma. Expert Opin Drug Safe 2015, 14: 559-570.
21.   Long GV, Stroyakovskiy D, Gogas H, et al. Dabrafenib and trametinib versus dabrafenib and placebo for Val600 BRAF-mutant melanoma: a multicentre, double-blind, phase 3randomised controlled trials.Lancet 2015, 386: 444-451.
22.   Larkin J, Ascierto PA, Creno B, et al. Combined vemurafenib and cobimetinib in BRAF-mutated melanoma. N Engl J Med 2014, 371: 1867-1876.
23.   Robert C, Karaszewska B, Schachter J, et al. Improved overall survival in melanoma with combined dabrafenib and trametrnib. N Engl J Med 2015, 372: 30-39.
24.   Curtin JA, Fridlyand J, Kageshita T, et al. Distinct sets of genetic alterations in melanoma. N Engl J Med 2005, 353: 2135-2147.
25.   Kakadia S, Yarlagadda N, Awad R, et al. Mechanisms of resistance to BRAF and MEK inhibitors and clinical update of US Food and Drug Administration-approved targeted therapy in advanced melanoma. Oncol Targets Ther 2018, 11:7095-7107.
26.   Kurata K, Onoda N, Noda S, etal. Growth arrest by activated BRAF and MEK inhibition in human anaplastic thyroid cancer cells. Int J Oncol 2016, 49: 2303-2308.
27.   Temraz S, Mukherji D, Shamseddine A.Dual inhibition of MEK and PI3K Pathway in KRAS and BRAF Mutated Colorectal Cancers.Int J MolSci 2015, 16: 22976-22988.
28.   Smyth T, Paraiso KHT, Hearn K, et al. Inhibition of HSP90 by AT13387 delays the emergence of resistance to BRAF inhibitors and overcomes resistance to dual BRAF and MEK inhibition in melanoma models. Mol Cance Ther 2014, 13: 2793-2804.
29.   Cabanillas M E, Ferrarotto R, Garden A S, et al. Neoadjuvant BRAF- and Immune-Directed therapy for anaplastic thyroid carcinoma. Thyroid2018, 28: 945-951.
30.   Iyer PC, Dadu R, Gule-Monroe M, et al. Salvage pembrolizumab added to kinase inhibitor therapy for the treatment of anaplastic thyroid carcinoma. J Immunother Cancer 2018, 6: 68.
No related articles found!