Targeted Therapy for Advanced Hurthle Cell Carcinoma of the Thyroid Gland

• The recent report by Ganly et al:
• They identified the importance of the:
• RTK / RAS /RAF / MAPK and PIK3 / AKT / mTOR pathways in this disease
• At least one receptor tyrosine kinase:
• Was mutated in 20% of HCC tumors, including:
• EGFR (2%)
• ERBB2 (11%)
• PDGFR (2%)
• TSHR (4%)
• MET (4%)
• RET (4%)
• PIK3CA mutations:
• Were found in 2% of HCC tumors and were:
• Mutually exclusive with PTEN mutations (4%)
• TSC1/2 mutations:
• Occurred in 6% of tumors
• NF1:
• Was deleted or mutated in 9% of tumors
• Mutations in NRAS, HRAS, or KRAS:
• Occurred in 15% of tumors:
• NRAS 9%
• HRAS 2%
• KRAS 4%
• Mutations in EIF1AX:
• Occurred in 11% of tumors, and mutations in other EIF1, 2, or 3 genes:
• Occurred in 9% of tumors
• In addition to these mutations:
• Genes which are overexpressed due to whole chromosome duplication of chromosome 7 were found, including:
• BRAF
• RHEB
• EIF3B
• There is currently a phase II randomized clinical trial of the multiple tyrosine kinase inhibitor sorafenib and the mTOR inhibitor everolimus in patients with widely invasive HCC:
• The preliminary evidence has shown a significant response rate for these agents, indicating the importance of this pathway in this cancer

#Arrangoiz #CancerSurgeon #ThyroidSurgeon #ParathyroidSurgeon #HeadandNeckSurgeon #SurgicalOncologist #ThyroidCancer #HCC #HurthleCellCarcinoma #Mexico #Miami #MSMC #MountSinaiMedicalCenter #Teacher #Surgeon

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