Maria E. Cabanillas, MD

Marie E. Cabanillas, MD, an oncologic endocrinologist at the University of Texas MD Anderson Cancer Center, discusses current unmet needs in advanced or metastatic 

According to Cabanillas, more options for 

mutations are another rare fusion requiring an inhibitor. Additionally, there are limitations on the 2 currently approved therapies, sorafenib (Nexavar) and lenvatinib (Lenvima).

For some patients, these therapies are too dangerous, according to Cabanillas. For patients who have a predisposition for bleeding, especially bleeding from the tumor 

inhibitors may be unsafe as they may increase bleeding risk. There is a need for more tolerable therapies for this patient population.

Videos

Marie E. Cabanillas, MD, discusses current unmet needs in advanced or metastatic TRK fusion-positive thyroid cancer. 

Unmet Needs in Advanced or Metastatic TRK Fusion-Positive Thyroid Cancer

Maria E. Cabanillas, MD, an oncologic endocrinologist, professor, and faculty director in the Department of Endocrine Neoplasia at The University of Texas MD Anderson Cancer Center, discusses the pooled results of 2 larotrectinib (Vitrakvi) trials (NCT02122913 and NCT02576431) for patients with advanced or metastatic 

The overall response rate (ORR) was 75% for the overall cohort, which included 19 patients with papillary thyroid cancer, 7 with anaplastic thyroid cancer, and 2 with follicular. Cabanillas says there were good results in these patients with differentiated thyroid cancers, where the ORR was 90%, including 2 patients with complete response (CR) 17 patients with a partial response (PR), and no patients with progressive disease (PD).

Patients with anaplastic thyroid cancer had an ORR of 29%, which is good for this population, according to Cabanillas. None of these patients had CR, 2 had PR, 1 had stable disease, and 3 patients had PD as their best response.

The analysis showed that the median duration of response in the overall cohort was not reached, which was impressive, Cabanillas says. The median time to response was 1.9 months. Treatment was ongoing in 68% of patients at the time of the data cutoff. For the overall cohort, the median progression-free survival was not met, and the median overall survival was 27.8 months.

Maria E. Cabanillas, MD, discusses the pooled results of 2 larotrectinib trials for patients with advanced or metastatic TRK fusion-positive thyroid cancer.

Larotrectinib Shows Efficacy in TRK Fusion Thyroid Cancer

Maria E. Cabanillas, MD, an oncologic endocrinologist, professor, and faculty director in the Department of Endocrine Neoplasia at The University of Texas MD Anderson Cancer Center, discusses the treatment landscape for patients with thyroid cancers harboring a 

 fusions occur specifically in differentiated thyroid cancer (DTC) and anaplastic thyroid cancer (ATC), as well as poorly DTC which is classified as another type of thyroid cancer, Cabanillas says. TRK fusions have not been observed in medullary thyroid cancer, however, limiting use of larotrectinib (Vitrakvi), a TRK inhibitor, to patients with DTC and ATC who harbor the 

For the treatment of patients with DTC, particularly those with advanced progressive disease, the options include 2 VGEF receptor inhibitors, sorafenib (Nexavar) and lenvatinib (Lenvima), Cabanillas says. The only effective therapy in ATC, however, is for patients harboring a 

 mutation, which is the FDA-approved combination of dabrafenib (Tafinlar) and trametinib (Mekinist). For patients with ATC who are not 

-mutated, there are no good therapies available at this time, according to Cabanillas.

It is important to recognize that although 

 fusions are rare in DTC and ATC, physicians should be checking for these rare fusions considering there are now selective therapies available for the population.

Maria E. Cabanillas, MD, discusses the treatment landscape for patients with thyroid cancers harboring a TRK fusion.

TRK Fusions Help to Fulfill Unmet Need in Thyroid Cancer Treatment Landscape

Maria E. Cabanillas, MD, oncologic endocrinologist, associate professor, MD Anderson Cancer Center, discusses the need for expediency of getting patients with anaplastic thyroid cancer treatment. Cabanillas says her and a team of medical professionals at MD Anderson Cancer Center set a goal of reducing the time between when they are contacted about a patient with anaplastic thyroid cancer, and when the patient is given an appointment time, to fewer than 5 business days.

Cabanillas says her and her team set a goal of reducing the time between when they are contacted about a patient with anaplastic thyroid cancer, and when the patient is given an appointment time, to fewer than 5 business days.

Maria E. Cabanillas, MD | Authors

Articles

Unmet Needs in Advanced or Metastatic TRK Fusion-Positive Thyroid Cancer

Larotrectinib Shows Efficacy in TRK Fusion Thyroid Cancer

TRK Fusions Help to Fulfill Unmet Need in Thyroid Cancer Treatment Landscape

Dr. Maria E. Cabanillas on Reducing Time to Treatment for Anaplastic Thyroid Cancer