Dr. Kristen Otto, a head and neck endocrine surgeon from Moffitt Cancer Center, explains when thyroid cancer patients should consider trial participation. Dr. Otto also discusses how research is shaping personalized care for thyroid cancer.
Dr. Kristen Otto is a Head and Neck Endocrine Surgeon and an Associate Member in the Department of Head & Neck – Endocrine Oncology at Moffitt Cancer Center. Learn more about Dr. Otto.
Related Resources
Transcript
Katherine Banwell:
Progress in new therapies, of course, wouldn’t be possible without clinical trials. When should someone consider a clinical trial participation?
Dr. Kristen Otto:
Unlike a lot of tumors, maybe more common tumors, we don’t have a lot of exposure to clinical trials for thyroid cancer patients. But I would say some of the obvious role for consideration for clinical trial would be patients who present with more advanced tumors. Specifically, tumors that have spread beyond the thyroid where we think that an upfront surgical approach is going to be either impossible or very difficult for the patient. We are now looking at strategies of trialing some of those targeted therapies before surgery to see if we can shrink tumors down and make tumors more amenable to surgery in the future.
So, that’s a real obvious one, where we would say, “If you have a tumor that’s a little bit more advanced than just something confined to the thyroid, think about referral for clinical trial.” Another one would be anybody who presents with widespread distant metastatic disease. Again, quite uncommon in thyroid cancer. But if that happens, we should always consider whether a trial is available.
Katherine Banwell:
In general, why do clinical trials matter? And how do they help improve care?
Dr. Kristen Otto:
It is how we decide what should become future standard of care. So, most things that are either FDA-approved or are considered current standard of care ultimately had their heyday in their clinical trial in the past. And so, we have to continue to push the science forward so that we can ever-improve outcomes for our patients.
Katherine Banwell:
How does participation differ from standard of care? What can patients expect day-to-day?
Dr. Kristen Otto:
As I mentioned before, thyroid cancer trials are a little less common than some other tumors. But in terms of expectations, typically, the medications, like I said, we oftentimes don’t have to go through insurance approvals for those drugs because they’re covered on the trial. You don’t have to go through insurance authorization for your follow-up scanning because that’s covered on the trial. So, usually, your whole surveillance plan is set out for you. It’s a pathway that’s set out for you by the guidelines of the trial.
Katherine Banwell:
Well, how has research changed what’s possible for thyroid cancer patients?
Dr. Kristen Otto:
I would say the best example is exactly what we were talking about with the targeted therapies, is particularly the targeted BRAF therapies. Because, as I mentioned in the intro, talking about the different types of thyroid cancer, and I mentioned that anaplastic thyroid cancer, the most feared, most aggressive, worst outcome thyroid cancer.
If you had this conversation with me 20 years ago, I would have said this is a universally fatal disease. Since we now understand that many anaplastic thyroid cancers are driven by the BRAF mutation, and now we have anti-BRAF therapy, we actually have a much better outcome than previously understood for those patients that do happen to have the BRAF mutation.