Pathologic complete response after neoadjuvant v-Raf murine sarcoma viral oncogene homolog B (BRAF) inhibition combined with immunotherapy therapy for anaplastic thyroid carcinoma: a case report and literature review

Endocr J. 2023 Feb 28;70(2):223-228. doi: 10.1507/endocrj.EJ22-0366. Epub 2022 Nov 9.

Abstract

Anaplastic thyroid carcinoma (ATC) is a highly malignant tumor with invasive nature. Most patients present with locally advanced and/or distant metastatic diseases that are difficult to treat. We report a case of a previously inoperable patient with v-Raf murine sarcoma viral oncogene homolog B (BRAF) mutated ATC. After a trial of neoadjuvant Dabrafenib/Trametinib with immunotherapy, the tumor became operable, and surgical pathology indicated a pathologic complete response (pCR). We also reviewed cases from the literature that utilized neoadjuvant BRAF-directed therapy in ATCs. These cases emphasize that BRAF-and immune-directed therapy is a feasible option in patients with inoperable ATC and may lead to improved outcomes.

Keywords: Anaplastic thyroid cancer; Immunotherapy; Neoadjuvant; Pathologic complete response; Tyrosine kinase inhibitors.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Humans
  • Immunotherapy
  • Mutation
  • Neoadjuvant Therapy
  • Oncogenes
  • Protein Kinase Inhibitors
  • Proto-Oncogene Proteins B-raf / genetics
  • Thyroid Carcinoma, Anaplastic*
  • Thyroid Neoplasms* / pathology

Substances

  • BRAF protein, human
  • Protein Kinase Inhibitors
  • Proto-Oncogene Proteins B-raf