Thyroid Cancer Presentations at American Thyroid Association: 88th Annual Meeting

October 2, 2018—The American Thyroid Association (ATA) will hold its 88^th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these regards thyroid cancer.

1. Dr. Marcia Brose of the Department of Otorhinolaryngology at the Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA, will present a study on the "Activity of Larotrectinib in Patients With Advanced TRK Fusion Thyroid Cancer." Tropomyosin receptor kinases (TRKs) are encoded by neurotrophic tyrosine receptor kinase (NTRK) genes. Fusion proteins involving NTRK genes are oncogenic and have been reported in a wide variety of malignancies, including nonmedullary thyroid cancer.
     
   Larotrectinib is a potent and highly selective oral TRK inhibitor. The researchers studied the activity and safety of larotrectinib, using seven patients who had undergone thyroidectomies but were diagnosed with advanced TRK-fusion thyroid cancer.Larotrectinib is highly active and was very well tolerated, with treatment-related adverse events being predominantly grade 1. All patients continued to receive larotrectinib treatment after the end of the study. These results strongly support the inclusion of NTRK gene fusions as part of routine molecular testing for patients with advanced thyroid cancer.

  

Dr. Gary Clayman of the Thyroid and Parathyroid Institute of Tampa General Hospital in Florida will describe his group's analysis of 217 patients with thyroid nodules and lymph nodes of concern for malignancy. His presentation is titled "A National Epidemic of Inadequate Preoperative Neck Ultrasound in the Evaluation of Suspicious or Malignant Thyroid Nodules and Cervical Lymph Nodes." High-resolution ultrasound evaluation of the central and lateral neck is considered the gold standard in the evaluation of thyroid cancer. Dr. Clayman's group hypothesized that comprehensive ultrasound evaluation of the neck would be commonplace throughout the United States, because it is an accurate predictor of complete surgical resection and long-term, disease-free regional control.
  
The 217 consecutive patients all provided preoperative ultrasound CDs to the Institute, prior to having additional high-resolution ultrasound evaluation and management of their primary thyroid malignancy at a tertiary referral center during 2017. Information from the evaluation included sonographic status of the thyroid and central and lateral neck lymph nodes, demographics, histopathologic variables, and cancer staging. Of the 66 males and 151 females with a median age of 41 years (range 14-87), 68 (31%) of the previous ultrasound studies were from the southwest region and 149 (69%) from the rest of the United States. The images and reports revealed that only 4 (2%) of the previous ultrasound studies found any lateral neck lymph nodes. However, the high-resolution preoperative ultrasound carried out by Dr. Clayman's group found 101 patients (46%) with T1, 39 (18%) with T2, and 77 (35%) with T3 or T4 thyroid malignancies.
  
The researchers concluded that preoperative analysis of suspicious and malignant thyroid nodules is inadequate in imaging centers throughout the United States and likely contributes to persistent thyroid malignancy, increased health care costs, and patient morbidity.

  

In a study titled "Recombinant human thyrotropin [rhTSH] vs. thyroid hormone withdrawal [THW] in radioactive iodine therapy of thyroid cancer patients with nodal metastatic disease: Influence of prognostic factors on follow-up clinical status," Dr. David Taieb of the Nuclear Medicine Department at La Timone Hospital in Marseille, France, and colleagues asked whether patients with well-differentiated thyroid cancers (DTC) would respond differently to radioiodine therapy (RIT) when they were prepared with rhTSH, as opposed to those prepared with THW.
  
While DTC has an excellent prognosis, patients' responses after thyroidectomy and RIT can be influenced by various factors, including age, number of nodes, location of nodes' invasion at diagnosis, and tumor stage. Researchers wanted to discover whether any of these factors effected the response to RIT. The 404 patients, with lymph node metastases and no evidence of distant metastasis at the time of RIT, were prepared with either rhTSH (205 patients) or THW (199). Patients and tumor characteristics were similar between the two groups for up to three years. None of the prognostic factors was found to be associated with different RIT outcomes after preparation with rhTSH versus THW.

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 The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95^th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

• The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  
• Annual scientific meetings
  
• Biennial clinical and research symposia
  
• Research grant programs for young investigators
  
• Support of online professional, public, and patient educational programs
  
• Development of guidelines for clinical management of thyroid disease and thyroid cancer

 The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

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