Tag Archive for: advanced thyroid cancer

Thyroid Cancer Research and Treatment Highlights

Thyroid Cancer Research and Treatment Highlights from Patient Empowerment Network on Vimeo.

What are the latest thyroid cancer research and treatment highlights? Dr. Lori Wirth discusses recent advancements, including successful clinical trials with newer therapies, and ongoing research into the latest targeted treatments for advanced thyroid cancer.

Dr. Lori Wirth is the Medical Director of the Center for Head and Neck Cancers at Massachusetts General Hospital. Learn more about Dr. Wirth.

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See More from Evolve Thyroid Cancer

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Understanding Targeted Thyroid Cancer Treatment Approaches

Understanding Targeted Thyroid Cancer Treatment Approaches

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What Questions Should You Ask About a Proposed Thyroid Cancer Treatment Plan?

What Are the Benefits of Thyroid Cancer Clinical Trial Participation?

What Are the Benefits of Thyroid Cancer Clinical Trial Participation?

Transcript:

Katherine:

Dr. Wirth, what are your research areas of focus? 

Dr. Wirth:

Here at Mass General in Boston we focus on clinical trials looking at new therapies for patients with advanced thyroid cancer including iodine refractory thyroid cancer, anaplastic thyroid cancer, medullary thyroid cancer.  

We also have a big program in studying in the laboratory what makes thyroid cancers tick in order to try to come up with new angles for new drug therapies based on preclinical work that’s being done.  

Katherine:

Okay. In terms of thyroid cancer are there research developments that are showing a lot of promise that you’re excited about? 

Dr. Wirth:

And so, Katherine, I’m so glad you’re asking that question because we’ve actually had some really big successes in clinical trials for patients with thyroid cancer recently. One of the big successes was a study called COSMIC-311 which looked at the drug cabozantinib (Cabometyx) in patients with iodine refractory thyroid cancer who had progressed on the first-line therapy.  

Most commonly that’s lenvatinib (Lenvima), but you can have other first-line therapies as well. And that study was a randomized Phase III study that was done in an international setting and showed that cabozantinib had very good activity in the second line following progression on first-line therapy.

So, we now have treatments lined up for patients for the first line, but then also we have good treatment for patients who’ve progressed on the first-line therapy and need further treatment. So, that was one major success. Another major success recently was the LIBRETTO-531 trial. So, that was a randomized Phase III trial also done internationally in patients with progressive RET-mutated medullary thyroid cancer.  

And that study randomized patients to receive either the RET specific therapy selpercatinib compared to a multikinase inhibitor either cabozantinib or vandetanib (Caprelsa). And the LIBRETTO-531 study showed that selpercatinib is much better than the older standard of care therapies in terms of response rates, durability of response. And we’re even seeing that it looks like there’s a signal where the overall survival is longer with serpercatinib compared to the older standard of care therapies.

So, whenever we have a strongly positive Phase II trial in oncology it’s a big win. And those are two examples of big wins recently. Another study that I would highlight has come out of Germany looking at the combination of pembrolizumab which is an immunotherapy drug in combination with lenvatinib the multikinase inhibitor in patients with anaplastic thyroid cancer.  

And it was a relatively small study. It was a Phase II trial, but this Phase II trial in Germany showed very good activity with this combination of pembrolizumab (Keytruda) and lenvatinib in people with anaplastic thyroid cancer. So, that is very promising for the future for those patients as well. 

Katherine:

Dr. Wirth, is there anything you’d like to add about the evolution of thyroid cancer care? Are you excited about anything that we haven’t already talked about? 

Dr. Wirth:

I am so excited about our recent evolution in thyroid cancer care where we’ve gone from only having old fashioned IV chemotherapy which really doesn’t work very well in thyroid cancer to having really effective multikinase inhibitors for thyroid cancer patients. And now we even have gene specific targeted therapies that work even better in certain specific situations. And so, this evolution over the last 10 years has really changed the landscape of therapies available to our patients. And we now have drugs for almost all of our patients with thyroid cancer.  

They have a good likelihood of working really well for a really long period of time. And that’s changed in my lifetime, taking care of people with thyroid cancer. And the progress that we’ve seen in the last 10 years is really only accelerating before our very eyes. One of the targets that we didn’t talk about earlier is the BRAF V600E mutation.

And I just want to talk about that very briefly because that’s actually the most common potentially targetable gene alteration in thyroid cancer. But thyroid cancer patients share that gene mutation with other cancers as well including melanoma, a subset of people with lung cancer, a subset of people with colorectal cancer as well. There are a lot of new drugs that are being studied in clinical trials targeting that BRAF V600E mutation and other cousins within that pathway of gene alterations that drive cancers.  

And so there is a very active industry that is working on developing the next best therapy for all of these targets that we’ve talked about, NTRK, RET, BRAF mutations, immunotherapy approaches to people with all different types of solid tumors. And those kinds of clinical trials are being done now in advanced thyroid cancer.

Whereas 15 years ago it was really difficult to get a trial up and running for people with thyroid cancer because it was seen as such a rare cancer, kind of a niche cancer where there’s not a lot of money to be made in developing drugs compared to the numbers of women with breast cancer or numbers of people with lung cancer.  

It’s a different story now. There’s a lot of active drug development specifically for people with thyroid cancer. 

Personalized Treatment Approaches in Advanced Thyroid Cancer Management

Personalized Treatment Approaches in Advanced Thyroid Cancer Management from Patient Empowerment Network on Vimeo.

How can advanced thyroid cancer be managed in a personalized way? Expert Dr. Megan Haymart from the University of Michigan discusses personalized treatment approaches and patient advice for optimal care, shared decision-making, and support programs.

[ACT]IVATION TIP

“…if your disease has progressed and you’ve seen an endocrinologist and maybe they don’t routinely give these targeted treatments, make sure you’re referred to an appropriate person who does. Two, I would encourage individuals to make sure that they had tumor sequencing, which means they can look at the tumor and see what is the mutation.”

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Emerging Advancements in Thyroid Cancer Treatment

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Addressing Socioeconomic Disparities in Thyroid Cancer Care

Advancing Thyroid Cancer Care: Tailored Treatment and Patient Involvement

Advancing Thyroid Cancer Care: Tailored Treatment and Patient Involvement

Transcript:

Lisa Hatfield:

Dr. Haymart, can you discuss the role of personalized medicine in managing advanced thyroid cancer, particularly tailoring treatments based on individual patient characteristics?

Dr. Megan Haymart:

So advanced thyroid cancer, when I think of those words I’m specifically talking about patients who have distant metastasis that is progressing. So it’s not just that they have a small site of sort of cancer recurrence that’s sort of stable. This is disease that’s progressing. And the things that have really changed in the past five to 10 years is we have more targeted treatments for these individuals.

There have been more clinical trials that have been completed, and these trials have shown which patients might be appropriate candidates for these treatments. And so my activation tip for this question is if you have advanced thyroid cancer, if you have disease that’s progressing, it’s not treated with standard therapy.

One, make sure you see physicians who are capable of treating this disease. So even though I see 95 percent of all thyroid cancer patients, I’m an endocrinologist and I actually, I’m not the one who gives these targeted treatments to the 5 percent or less who have advanced disease, I would refer them to my medical oncology colleague. And so, if your disease has progressed and you’ve seen an endocrinologist and maybe they don’t routinely give these targeted treatments, make sure you’re referred to an appropriate person who does.

Two, I would encourage individuals to make sure that they had tumor sequencing, which means they can look at the tumor and see what is the mutation. And it’s possible that there’s either an already available drug or a clinical trial that’s targeted towards their specific tumor mutation.

Lisa Hatfield:

Dr. Haymart, how can patients engage in shared decision-making with their healthcare providers to determine the most appropriate treatment approach for their thyroid cancer? And what role do patient navigators or support programs play in improving outcomes for disadvantaged patients navigating the complexities of thyroid cancer treatments?

Dr. Megan Haymart:

So a key thing here for thyroid cancer  for 95 percent of patients is you have time on your side. So patients shouldn’t feel rushed to make a decision. So you have your clinic visit, you don’t need to make a decision on your treatment by the end of the visit. You can gather more information, so you can read more using reliable resources that your physician recommends. You can talk to your friends and family members. You can tell your healthcare provider, “You know, I appreciate the information that you gave me. I need more time to process this. I’ll be in touch with you.”

So patients don’t need to feel rushed during that decision-making process. It’s important that they know that for most of the time, for thyroid cancer, it’s preference sensitive decisions, meaning shared decision-making is totally appropriate. There’s no right or wrong answer in many of these scenarios.

And so the patients can really tailor it to them and what their priorities are. There’s been less data on patient navigators in the realm of thyroid cancer, but for other cancers, it’s been shown to be very useful and helpful, and patients have had positive responses to working with patient navigators. But if they aren’t available at your institution, don’t feel bad about bringing in a family member or a friend as an extra set of ears, and as someone that you can talk things over with later.