Surgery After BRAF-Directed Therapy Is Associated with Improved Survival in BRAF V600E Mutant Anaplastic Thyroid Cancer: A Single-Center Retrospective Cohort Study

作者：Xiao Ling Zhao, Jennifer Rui Wang, Ramona Dadu, Naifa Lamki Busaidy, Lei Xu, Kim O. Learned, Noah N. Chasen, Thinh H. Vu, Anastasios Maniakas, Arturo A. Eguia, Julia Diersing, Neil D. Gross, Ryan P. Goepfert, Stephen Yenzen Lai, Marie-Claude C. Hofmann, Renata Ferrarotto, Charles S. Lu, Gary Brandon Gunn, Michael T. Spiotto, Vivek Subbiah, Michelle D. Williams, Maria E. Cabanillas, Mark Zafereo · 发表于：Thyroid · 年份：2023 · 被引用次数：109 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Cancer-related Molecular Pathways

Background: The aim of this study was to describe the oncologic outcomes of patients with BRAF V600E -mutated anaplastic thyroid cancer (ATC) who had neoadjuvant BRAF-directed therapy with subsequent surgery. For context, we also reviewed patients who received BRAF-directed therapy after surgery, and those who did not have surgery after BRAF-directed therapy. Methods: This was a single-center retrospective cohort study conducted at a tertiary care cancer center in Texas from 2017 to 2021. Fifty-seven consecutive patients with BRAF V600E -mutated ATC and at least 1 month of BRAF-directed therapy were included. Primary outcomes were overall survival (OS) and progression-free survival (PFS). Results: All patients had stage IVB (35%) or IVC (65%) ATC. Approximately 70% of patients treated with BRAF-directed therapy ultimately had surgical resection of residual disease. Patients who had neoadjuvant BRAF-directed therapy followed by surgery ( n = 32) had 12-month OS of 93.6% [confidence interval (CI) 84.9–100] and PFS of 84.4% [CI 71.8–96.7]. Patients who had surgery before BRAF-directed therapy ( n = 12) had 12-month OS of 74.1% [CI 48.7–99.5] and PFS of 50% [CI 21.7–78.3]. Finally, patients who did not receive surgery after BRAF-directed therapy ( n = 13) had 12-month OS of 38.5% [CI 12.1–64.9] and PFS of 15.4% [CI 0–35.0]. Neoadjuvant BRAF-directed therapy reduced tumor size, extent of surgery, and surgical morbidity score. Subgroup analysis suggested that any residual ATC in th...