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Neoadjuvant tyrosine kinase inhibitor therapy in locally advanced differentiated thyroid cancer: a single centre case series

Published online by Cambridge University Press:  22 March 2023

J J Y Yeo Open the ORCID record for J J Y Yeo [Opens in a new window] ,
K Stewart ,
P Maniam ,
S Arman ,
D Srinivasan ,
L Wall ,
M MacNeill ,
M Strachan  and
I Nixon
J J Y Yeo*
Affiliation:
Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
K Stewart
Affiliation:
Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
P Maniam
Affiliation:
Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
S Arman
Affiliation:
Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
D Srinivasan
Affiliation:
Department of Oncology, Western General Hospital, Edinburgh, UK
L Wall
Affiliation:
Department of Oncology, Western General Hospital, Edinburgh, UK
M MacNeill
Affiliation:
Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh, UK
M Strachan
Affiliation:
Metabolic Unit, Western General Hospital, Edinburgh, UK
I Nixon
Affiliation:
Department of Head and Neck Surgery, St John's Hospital at Howden, Livingston, UK
*
Corresponding author: Dr JJY Yeo; Email: justinjuiyuanyeo@hotmail.com
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Abstract

Objective

Primary surgical resection remains the mainstay of management in locally advanced differentiated thyroid cancer. Tyrosine kinase inhibitors have recently shown promising results in patients with recurrent locally advanced differentiated thyroid cancer. This study discussed four patients with locally advanced differentiated thyroid cancer managed with tyrosine kinase inhibitors used prior to surgery in the ‘neoadjuvant’ setting.

Method

Prospective data collection through a local thyroid database from February 2016 identified four patients with locally advanced differentiated thyroid cancer unsuitable for primary surgical resection commenced on neoadjuvant tyrosine kinase inhibitor therapy.

Results

All cases had T4a disease at presentation. Three cases tolerated tyrosine kinase inhibitor therapy for more than 14 months while the last case failed to tolerate treatment at 1 month. All patients subsequently underwent total thyroidectomy to facilitate adjuvant radioactive iodine treatment. Disease-specific survival remains at 100 per cent currently (range, 29–75 months).

Conclusion

Neoadjuvant tyrosine kinase inhibitors in locally advanced differentiated thyroid cancer can be effective in reducing primary tumour extent to potentially facilitate a more limited surgical resection for local disease control.

Keywords

Thyroid neoplasmscarcinoma, papillarytreatment outcometyrosine protein kinase inhibitorsantineoplastic agents

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 11 , November 2023 , pp. 1237 - 1243
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr J J Y Yeo takes responsibility for the integrity of the content of the paper

Presented at the British Association of Endocrine and Thyroid Surgeons meeting, 8 October 2021, Leeds, UK, and at the European Society of Surgical Oncology meeting, 20 October 2022, Bordeaux, France.

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