Complete pathological response following chemotherapy and radiotherapy in two cases of advanced anaplastic thyroid carcinoma
Introduction: Anaplastic thyroid carcinoma (ATC) is the most aggressive form of thyroid cancer with a bleak prognosis. Favorable outcomes are rare but help decipher molecular pathophysiology, investigate prognosis factors, and discover new therapeutic targets. Case presentation: Two patients were...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-01-01
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| Series: | European Thyroid Journal |
| Subjects: | |
| Online Access: | https://etj.bioscientifica.com/view/journals/etj/12/1/ETJ-22-0111.xml |
| _version_ | 1811177297139466240 |
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| author | Benjamin Chevalier Oriane Karleskind Arnaud Jannin Olivier Farchi Catherine Vermaut Alexandre Escande Clio Baillet Stéphanie Espiard Marie-Christine Vantyghem Bruno Carnaille Emmanuelle Leteurtre Christine Do Cao |
| author_facet | Benjamin Chevalier Oriane Karleskind Arnaud Jannin Olivier Farchi Catherine Vermaut Alexandre Escande Clio Baillet Stéphanie Espiard Marie-Christine Vantyghem Bruno Carnaille Emmanuelle Leteurtre Christine Do Cao |
| author_sort | Benjamin Chevalier |
| collection | DOAJ |
| description | Introduction: Anaplastic thyroid carcinoma (ATC) is the most aggressive form of thyroid cancer with a bleak prognosis. Favorable outcomes are rare but help decipher molecular pathophysiology, investigate prognosis factors, and discover new therapeutic targets.
Case presentation: Two patients were diagnosed with locally advanced nonresectable ATC, one with metastatic extension. Each patient received chemotherapy and radiotherapy, allowing thyroid surgical resection. In both cases, the pathological examination was consistent with complete response with no viable tumor cells. After follow-ups of 48 and 70 months, both patients remain disease-free. Molecular explorations on thyroid biopsies revealed microsatellite instability (MSI) and alterations on mismatch repair– gene complex, also PTEN and ATM variants in both cases. Both also presented with non-classical immune infiltrate composed of equal parts T CD4 + lymphocytes and macrophages.
Conclusion: We report two cases of patients cured from advanced ATC and fo r the first time provide genetic and immunological explorations in this setting. It seems with these two cases that MSI-ATCs may indicate a better prognosis. Our study hypothesizes different responsible mechanisms including increased sensitivity to chemoradiotherapy and/or immune tumor infiltrate modulation. |
| first_indexed | 2024-04-10T23:00:28Z |
| format | Article |
| id | doaj.art-b439f355144a41caabf50eb3bbba0b91 |
| institution | Directory Open Access Journal |
| issn | 2235-0802 |
| language | English |
| last_indexed | 2024-04-10T23:00:28Z |
| publishDate | 2023-01-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | European Thyroid Journal |
| spelling | doaj.art-b439f355144a41caabf50eb3bbba0b912023-01-14T01:38:23ZengBioscientificaEuropean Thyroid Journal2235-08022023-01-0112119https://doi.org/10.1530/ETJ-22-0111Complete pathological response following chemotherapy and radiotherapy in two cases of advanced anaplastic thyroid carcinomaBenjamin Chevalier0Oriane Karleskind1Arnaud Jannin2Olivier Farchi3Catherine Vermaut4Alexandre Escande5Clio Baillet6Stéphanie Espiard7Marie-Christine Vantyghem8Bruno Carnaille9Emmanuelle Leteurtre10Christine Do Cao11Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, France; University of Lille, Lille, FranceDepartment of Pathology, Lille University Hospital, Lille, FranceDepartment of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, France; University of Lille, Lille, FranceDepartment of Biochemistry and Molecular Biology, Hormonology Metabolism Nutrition Oncology, Lille University Hospital, Lille, FranceDepartment of Biochemistry and Molecular Biology, Hormonology Metabolism Nutrition Oncology, Lille University Hospital, Lille, FranceAcademic Department of Radiation Oncology, Oscar Lambret Comprehensive Cancer Center, Lille, France; CRIStAL UMR CNRS 9189, University of Lille, Villeneuve-d’Ascq, FranceDepartment of Nuclear Medicine, Lille University Hospital, Lille, FranceDepartment of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, France; University of Lille, Lille, France; Institut National de la Santé et de la Recherche Médicale (INSERM), European Genomic Institute for Diabetes (EGID), CHU Lille, Lille, FranceDepartment of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, France; University of Lille, Lille, France; Institut National de la Santé et de la Recherche Médicale (INSERM), European Genomic Institute for Diabetes (EGID), CHU Lille, Lille, FranceUniversity of Lille, Lille, FranceUniversity of Lille, Lille, France; Department of Pathology, Lille University Hospital, Lille, France; University of Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, FranceDepartment of Endocrinology, Diabetology and Metabolism, Lille University Hospital, Lille, FranceIntroduction: Anaplastic thyroid carcinoma (ATC) is the most aggressive form of thyroid cancer with a bleak prognosis. Favorable outcomes are rare but help decipher molecular pathophysiology, investigate prognosis factors, and discover new therapeutic targets. Case presentation: Two patients were diagnosed with locally advanced nonresectable ATC, one with metastatic extension. Each patient received chemotherapy and radiotherapy, allowing thyroid surgical resection. In both cases, the pathological examination was consistent with complete response with no viable tumor cells. After follow-ups of 48 and 70 months, both patients remain disease-free. Molecular explorations on thyroid biopsies revealed microsatellite instability (MSI) and alterations on mismatch repair– gene complex, also PTEN and ATM variants in both cases. Both also presented with non-classical immune infiltrate composed of equal parts T CD4 + lymphocytes and macrophages. Conclusion: We report two cases of patients cured from advanced ATC and fo r the first time provide genetic and immunological explorations in this setting. It seems with these two cases that MSI-ATCs may indicate a better prognosis. Our study hypothesizes different responsible mechanisms including increased sensitivity to chemoradiotherapy and/or immune tumor infiltrate modulation.https://etj.bioscientifica.com/view/journals/etj/12/1/ETJ-22-0111.xmlanaplastic thyroid carcinomasarcomatoidcomplete pathological responsemismatch repairimmune microenvironment |
| spellingShingle | Benjamin Chevalier Oriane Karleskind Arnaud Jannin Olivier Farchi Catherine Vermaut Alexandre Escande Clio Baillet Stéphanie Espiard Marie-Christine Vantyghem Bruno Carnaille Emmanuelle Leteurtre Christine Do Cao Complete pathological response following chemotherapy and radiotherapy in two cases of advanced anaplastic thyroid carcinoma European Thyroid Journal anaplastic thyroid carcinoma sarcomatoid complete pathological response mismatch repair immune microenvironment |
| title | Complete pathological response following chemotherapy and radiotherapy in two cases of advanced anaplastic thyroid carcinoma |
| title_full | Complete pathological response following chemotherapy and radiotherapy in two cases of advanced anaplastic thyroid carcinoma |
| title_fullStr | Complete pathological response following chemotherapy and radiotherapy in two cases of advanced anaplastic thyroid carcinoma |
| title_full_unstemmed | Complete pathological response following chemotherapy and radiotherapy in two cases of advanced anaplastic thyroid carcinoma |
| title_short | Complete pathological response following chemotherapy and radiotherapy in two cases of advanced anaplastic thyroid carcinoma |
| title_sort | complete pathological response following chemotherapy and radiotherapy in two cases of advanced anaplastic thyroid carcinoma |
| topic | anaplastic thyroid carcinoma sarcomatoid complete pathological response mismatch repair immune microenvironment |
| url | https://etj.bioscientifica.com/view/journals/etj/12/1/ETJ-22-0111.xml |
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