Initial Management of BRAF V600E-Variant Anaplastic Thyroid Cancer: The FAST Multidisciplinary Group Consensus Statement.

Autor:	Hamidi S; Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer, Houston., Dadu R; Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer, Houston., Zafereo ME; Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer, Houston., Ferrarotto R; Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer, Houston., Wang JR; Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer, Houston., Maniakas A; Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer, Houston., Gunn GB; Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston., Lee A; Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston., Spiotto MT; Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston., Iyer PC; Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer, Houston., Sousa LG; Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer, Houston., Akhave NS; Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer, Houston., Ahmed S; Department of Neuroradiology, The University of Texas MD Anderson Cancer, Houston., Learned KO; Department of Neuroradiology, The University of Texas MD Anderson Cancer, Houston., Lu C; Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer, Houston., Lai SY; Department of Head & Neck Surgery, The University of Texas MD Anderson Cancer, Houston.; Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston., Williams M; Department of Pathology, The University of Texas MD Anderson Cancer, Houston., Hosseini SM; Department of Pathology, The University of Texas MD Anderson Cancer, Houston., Busaidy NL; Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer, Houston., Cabanillas ME; Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer, Houston.
Jazyk:	angličtina
Zdroj:	JAMA oncology [JAMA Oncol] 2024 Sep 01; Vol. 10 (9), pp. 1264-1271.
DOI:	10.1001/jamaoncol.2024.2133
Abstrakt:	Importance: BRAF/MEK inhibitors revolutionized the treatment of BRAF V600E-variant anaplastic thyroid carcinoma (BRAFv-ATC), offering improved outcomes for patients with this previously incurable disease. Observations: Anaplastic thyroid carcinoma (ATC) accounts for approximately half of thyroid cancer-related deaths. It presents as a rapidly growing tumor that often invades locoregional structures and spreads to distant sites early; therefore, prompt diagnosis, staging, and treatment initiation are of the essence in the treatment of ATC. Although most oncologists will encounter a patient with ATC in their practice, the rarity of this disease makes treatment challenging, particularly because those with BRAFv-ATC no longer have a dismal prognosis. BRAF/MEK kinase inhibitors have transformed the outlook and treatment of BRAFv-ATC. Therefore, molecular profiling to identify these patients is critical. More recently, the addition of immunotherapy to BRAF/MEK inhibitors as well as the use of the neoadjuvant approach were shown to further improve survival outcomes in BRAFv-ATC. Many of these recent advances have not yet been incorporated in the currently available guidelines, allowing for disparities in the treatment of patients with BRAFv-ATC across the US. With the increasing complexity in the management of BRAFv-ATC, this Consensus Statement aims to formulate guiding recommendations from a group of experts to facilitate therapeutic decision-making. Conclusions and Relevance: This Consensus Statement from the FAST (Facilitating Anaplastic Thyroid Cancer Specialized Treatment) group at MD Anderson Cancer Center emphasizes that rapid identification of a BRAF V600E pathogenic variant and timely initiation of sequential therapy are critical to avoid excess morbidity and mortality in patients with BRAFv-ATC. In the past decade, remarkable progress has been made in the treatment of patients with BRAFv-ATC, justifying these new evidence-based recommendations reached through a consensus of experts from a high-volume center.
Databáze:	MEDLINE
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