Refractory thyroid cancer has a new way to deal with Fudan Cancer Hospital released the latest research results

Thyroid cancer is often considered a malignancy that works well. However, clinically, 5% of locally advanced patients still face the dilemma of inability to operate, wide range of surgery, large trauma, and high local recurrence rate, which is one of the main causes of death of thyroid cancer patients. Recently, the research results on the neoadjuvant treatment of thyroid cancer published by Professor Wang Yu, director of the Department of Head and Neck Surgery of Fudan University Affiliated Cancer Hospital, successfully filled the "gap" in the treatment of locally advanced thyroid cancer for the first time in the world. The relevant papers were published online at the same time as the international authoritative journal in the field of thyroid diseases (Thyroid).

"The incidence of thyroid cancer has shown a significant upward trend in recent years, and the incidence of thyroid cancer in China has increased by nearly 3 times in the past 30 years. In Shanghai, the incidence of thyroid cancer has become the second highest incidence of cancer in women," professor Wang Yu said, "at present, multidisciplinary comprehensive treatment based on surgery is the main method of curing thyroid cancer, which can obtain very good efficacy, for example, in Fudan Cancer Hospital, thyroid cancer 5-year survival rate can reach more than 98%." However, not all thyroid cancer patients are 'lucky', for example, some locally advanced thyroid cancer patients who have lost the opportunity for surgical radical cure are not optimistic due to the lack of treatment measures. Even if there have been previous attempts to obtain surgical opportunities for these patients through new adjuvant targeted therapy, they are limited to individual case reports, and there is no complete clinical trial protocol and related reports. ”

In order to enable more patients with locally advanced thyroid cancer to have the opportunity to surgically completely remove the tumor, Professor Wang Yu led a team to carry out a clinical study on the targeted drug allotinib in the neoadjuvant therapy of locally advanced thyroid cancer. Professor Wang Yu said, "This drug is currently approved for use in the treatment of advanced thyroid cancer and has been shown to benefit patients significantly. We try to apply it to patients with locally advanced thyroid cancer, and according to its efficacy, we will provide patients with surgical opportunities and protect the function of important organs as much as possible, and then improve the treatment effect with later treatment. ”

It is understood that the study included 13 patients with locally advanced thyroid cancer that could not be directly cured by surgery, and each patient received an average of 3.5 cycles of allotinib neoadjuvant therapy to evaluate the possibility of surgery. Nine of these patients achieved the desired results and eventually underwent radical resection. "This result is the first successful demonstration of the effectiveness of anlotinib in the neoadjuvant treatment of thyroid cancer, which has won the opportunity for surgery for patients with advanced stages; at the same time, more importantly, the neoadjuvant therapy model is expected to become a new option for local advanced thyroid cancer treatment." Professor Wang Yu said.

As the largest thyroid cancer diagnosis and treatment center in China, the annual outpatient volume of head and neck surgery in the Affiliated Cancer Hospital of Fudan University exceeds 110,000 cases, and on the basis of the previous traditional traditional surgical system, it has expanded and completed the personalized minimally invasive surgery system for head and neck tumors with da Vinci robot surgery as the core, with a total annual surgical volume of more than 8,500 units, and the annual thyroid cancer surgery volume ranks first among major cancer diagnosis and treatment centers in China. The 5-year survival rate of thyroid cancer patients is 98.35%, which is comparable to the current level of the top thyroid cancer centers in the world. In addition to the research and treatment of the new auxiliary mode of locally advanced thyroid cancer, under the leadership of Professors Ji Qinghai, Li Duanshu, Wu Yi and Wang Yu, the Department of Head and Neck Surgery of Cancer Hospital combined the advantages of the hospital's clinical trial platform with the advantages of MDT of head and neck tumors, established an integrated clinical research process for advanced thyroid cancer and head and neck squamous cell carcinoma, and actively "declared war" on more types of refractory thyroid cancer. For example, a pathological subtype with the highest degree of malignancy and a very poor prognosis among all thyroid tumors, the undifferentiated carcinoma of the thyroid gland, is the only tumor that has been diagnosed as stage IV once diagnosed, with a very high degree of malignancy, rapid progression, and a very poor prognosis, and the average survival period of patients is often less than 6 months; and because of the relatively low incidence of this type of thyroid cancer and the lack of understanding among the public, the best intervention time has been missed at the time of consultation, so it is called "extremely dangerous" thyroid cancer.

In order to make this "incurable" thyroid cancer "treatable", the "process specification + teamwork" of the multidisciplinary comprehensive diagnosis and treatment model of head and neck surgery in cancer hospitals opens the "door of life" for these patients. After discussion by a multidisciplinary team or a comprehensive assessment of a multidisciplinary outpatient clinic for advanced thyroid cancer, a treatment plan was "tailored" for patients with undifferentiated thyroid cancer, and the multidisciplinary team worked closely together to implement the treatment plan.

In recent years, targeted therapy has also been increasingly applied to patients with advanced undifferentiated thyroid cancer that cannot be surgically removed. The Department of Head and Neck Surgery of Cancer Hospital has carried out extensive clinical trial research, and the ongoing phase II clinical trial of "famitinib malate combined with carellizumab therapy" has a remarkable effect on early treatment. Professor Wang Yu said that the multidisciplinary team of head and neck tumors of Fudan University Affiliated Cancer Hospital will work together to continuously explore and provide standardized, reasonable, scientific and optimal comprehensive treatment for patients with head and neck tumors including local advanced thyroid cancer.

Correspondent Wang Guangzhao Xinmin Evening News reporter Zuo Yan