Italy is the first European country to approve an effective combination of drugs for this type of cancer, for which the average patient survival of a few months
Anaplastic thyroid cancer a very rare type of cancerbut particularly aggressive and difficult to manage because it grows quickly and d distant metastasis very early, so much so as to still leave a few months of life to patients today. There is a new cure that manages to slow the progression of the disease, reduce its size and significantly lengthen the survival of the sick. The combination of two targeted drugs, dabrafenib and trametinibin fact it was approved a few days ago by the Italian Medicines Agency (Aifa) and ours the first European country to make innovative therapy available for this type of cancer, for which effective options are still scarce.
A rare and lethal subtype
With over 13,200 new cases registered every year, thyroid carcinoma is one of the most frequent tumors in Italy, particularly in young women under 40 (among which in second place for diffusion after breast cancer), but fortunately also one of the least dangerous, so much so that about 97% of the patients are alive 10 years after diagnosis. In fact, in the vast majority of cases, these are microcarcinomas that are not very dangerous and must very often be kept under observation without intervening, in order not to subject the patients unnecessarily to the undesirable consequences of the therapies. Anaplastic carcinoma is a fortunately very rare subtype of thyroid cancer (it represents about 1% of new cases per year, i.e. it affects just over 1,300 compatriots), but unfortunately with a high mortality rate – he explains Laura Locati, director of medical oncology at the IRCCS Maugeri of Pavia —. It usually hits people between 60 and 80 years old. very aggressive, characterized by a local growth in the thyroid and in the neck with involvement of blood vessels, larynx, oesophagus and with rapid dissemination to other organs, so that 70-80% of patients inoperable at diagnosis. Thus the average survival of patients is only six months after the discovery of the neoplasm.
Symptoms and therapies
The most common symptom of thyroid cancer palpation response (or observation in tests performed for other reasons) of a lump on the neck. Only a small fraction (about 3-5%) of all thyroid nodules are due to malignant tumors. However, the presence of a nodule should never be underestimated: you need to talk to the family doctor, who prescribes a visit to a specialistan ultrasound of the neck and specific hormonal tests to ascertain the nature of the lesion. Anaplastic carcinoma grows quickly, often causing noticeable swellingdifficulty swallowing (dysphagia), changes in the tone of the voice (dysphonia) – clarifies Locati, associate professor of Medical Oncology at the Department of Internal Medicine and Medical Therapy of the University of Pavia -: these are signs of a neoplasm that is generally already in an advanced stage. When surgery is not possible, the possibility of proceeding with radiotherapy and chemotherapy which can provide local tumor control, but have no impact on overall survival in patients with metastases.
The new therapy for patients with BRAF mutation
However, better results can be achieved with the combination of dabrafenib and trametinib: More than half of patients with metastatic disease achieve important regressions of tumor lesions – says the expert -, increasing the median survival ranged from 6 to 14 months. In patients with neoplasm confined to the thyroid (therefore without metastases) but inoperable at diagnosis, this targeted therapy in some cases has even reduced the tumor so much as to allow surgery, which is the indispensable step in order to be able to hope for a definitive recovery. Equally important, these drugs are well tolerated, in fact less than 20% of patients have to interrupt the treatment due to toxicity. The combination of medicines approved in the USA since 2018but in Europe, despite these results obtained in an orphan tumor (i.e. for which there are no other effective treatment strategies), Italy is the first country to have given the go-ahead: Thanks to the law 648/96which allows you to dispense a drug fully paid for by the National Health Service when there is no valid therapeutic alternative, Dabrafenib and trametinib are now available for patients with BRAF-mutated anaplastic thyroid cancer – concludes Locati -. About 40-50% of anaplastic thyroid cancers have the BRAF mutation. These are so-called medicines “tumor growth inhibitors” which act against tumors more selectively than traditional chemotherapy, as they recognize certain proteins found on the wall or inside tumor cells and block the mechanisms by which they reproduce.
April 5, 2023 (change April 5, 2023 | 06:38)
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