Feasibility of Short-Term Redifferentiation in Patients with Radioactive Iodine-Refractory Metastatic Thyroid Cancer

von Hinten J., Viering O., Bundschuh R. A., Cagliyan F., Wengenmair H., Pfob C. H., ...Daha Fazla

Journal of nuclear medicine : official publication, Society of Nuclear Medicine, cilt.66, sa.8, ss.1192-1196, 2025 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 66 Sayı: 8
  • Basım Tarihi: 2025
  • Doi Numarası: 10.2967/jnumed.125.270055
  • Dergi Adı: Journal of nuclear medicine : official publication, Society of Nuclear Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Biotechnology Research Abstracts, CAB Abstracts, Veterinary Science Database
  • Sayfa Sayıları: ss.1192-1196
  • Anahtar Kelimeler: kinase inhibition, metastatic differentiated thyroid carcinoma, radioiodine-refractory thyroid cancer, redifferentiation
  • Marmara Üniversitesi Adresli: Evet

Özet

Radioactive iodine-refractory thyroid cancer (TC) has a poor prognosis, and restoring iodine uptake is a major therapeutic goal. Recent studies have used tyrosine kinase inhibitors (TKIs) for 3-6 wk to achieve redifferentiation, but preclinical data suggest that maximal effects occur within 8-12 d. Methods: In this retrospective study, 8 patients with metastatic radioactive iodine-refractory TC received trametinib plus dabrafenib (for BRAF-mutated disease) or trametinib alone (for BRAF wild-type disease) for 10 d. Iodine uptake was assessed by 123I-scintigraphy; responders received high-dose radioactive iodine therapy, and nonresponders continued TKIs for another 10 d. Results: Two patients (both with BRAF wild-type disease) achieved successful iodine uptake restoration with significant thyroglobulin reduction after radioactive iodine therapy. Extending TKI treatment to 21 d did not yield further benefit. Conclusion: Our pilot study supports preclinical findings that maximal restoration of iodine uptake is achieved after only 10 d of TKI therapy, reducing toxicity and treatment costs. Longer treatment did not provide any additional benefit. Larger prospective trials are needed to confirm these findings.