THYROID CANCERS

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Pembrolizumab (Keytruda) demonstrated promising antitumor activity with durable responses in patients with advanced thyroid cancer, according to results from the KEYNOTE-028 trial presented at the 2016 ASCO Annual Meeting. The overall response rate (ORR) with the PD-1 inhibitor was 9.1%, which included 2 partial responses (PR).

We present a case of a 49-year-old woman with a pT4aN1B papillary thyroid cancer who underwent radical thyroidectomy with bilateral neck dissection and RAI I-131 ablation, but poorly tolerated TSH suppression therapy due to tachycardia. Rising thyroglobulin levels and lymph node mapping showed recurrent/progressive disease in the thyroid bed.

The kinase inhibitors sorafenib (Nexavar) and lenvatinib (Lenvima) have significantly altered the treatment paradigm for patients with advanced radioactive iodine (RAI)-refractory differentiated thyroid cancer in both older and younger populations, with combination strategies hoping to further build upon this success.