European Thyroid Journal最新文献

{"title":"NOVEL INSIGHTS IN ADVANCED THYROID CARCINOMA: FROM MECHANISMS TO TREATMENTS: Molecular insights into the origin, biology, and treatment of anaplastic thyroid carcinoma.","authors":"Amir Hossein Karimi, Peter Yf Zeng, Matthew Cecchini, John W Barrett, Harrison Pan, Shengjie Ying, Nhi Le, Joe S Mymryk, Laurie E Ailles, Anthony C Nichols","doi":"10.1530/ETJ-25-0057","DOIUrl":"10.1530/ETJ-25-0057","url":null,"abstract":"<p><p>Anaplastic thyroid carcinoma (ATC) is among the most daunting entities in clinical oncology. Large-scale genomic studies of thyroid cancer within the last decade have uncovered a distinct set of recurrent somatic alterations implicated in the development, aggressiveness, and treatment resistance of ATC. The sequence of events leading to the development of ATC commonly begins with a tumorigenic mutation that constitutively activates the mitogen-activated protein kinase (MAPK) pathway, giving rise to indolent entities such as well-differentiated papillary or follicular thyroid carcinomas. This is followed by recurring alterations that drive oncogenic properties such as enhanced proliferation, genomic instability, replicative immortality, and dedifferentiation, culminating in the emergence of highly aggressive ATC tumors. The truncal MAPK-activating events present therapeutic opportunities, as small molecule inhibitors against key components of this pathway are available. Indeed, genotype-guided targeting of the MAPK pathway is now the standard of care for subgroups of ATC patients, and further efforts exploring additional MAPK inhibitors and the combination of immune checkpoint blockade with MAPK inhibition are overcoming resistance to the current targeted therapies in the clinic and expanding our arsenal against this disease. In this review, we summarize the current understanding of the genomic landscape of ATC, discuss the biological and clinical ramifications of recurring aberrations, and provide an overview of the opportunities and challenges in the clinical management of this lethal malignancy.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of treated hyper- and hypo-thyroidism and sociodemographic and geographic disparities in France in 2020.","authors":"Joel Coste, Laurence Mandereau-Bruno, Xavier Bertagna, Jean-Louis Wemeau","doi":"10.1530/ETJ-25-0041","DOIUrl":"https://doi.org/10.1530/ETJ-25-0041","url":null,"abstract":"<p><p>Background Healthcare claims data are increasingly used to investigate the epidemiology of benign thyroid diseases. Here we estimate the prevalence of treated hyper- and hypo-thyroidism and assess the potential sociodemographic and geographic disparities in France in 2020 given the country's poor epidemiological knowledge of these conditions. Methods We used the French national health data system, which covers nearly the entire population residing in France (over 67 million inhabitants in metropolitan and overseas departments). Prevalent cases were identified based on patients' long-term disease status, hospitalisation for hyper- and hypothyroidism and reimbursements for thyroid hormones, antithyroid drugs, iodine-131 and thyroid surgery. Thyroid stimulating hormone, antithyroid antibodies and previous therapy for thyroid cancer and hyperthyroidism were considered to characterise the origin and surveillance of hypothyroidism. Results In 2020, we identified 112,992 and 2,986,333 cases of treated hyper- and hypothyroidism, respectively, with an overall prevalence of 0.17 and 4.45 per 100 inhabitants. Marked differences were observed in terms of sex, age group and geographic area (department) for both conditions and deprivation level of the place of residence for hyperthyroidism only. The proportion of hypothyroidism following previous therapy for thyroid cancer or hyperthyroidism was less than 10%. Adequate monitoring (thyroid stimulating hormone checked in the past year) occurred in 73.7% of hypothyroid subjects, with large variations across departments. Conclusions This study provides prevalence estimates of treated hyper- and hypothyroidism at the national and departmental levels in France and improves epidemiological knowledge of both conditions. It also supports using health claims data for their epidemiological surveillance.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of the calcium stimulation test in diagnosing medullary thyroid cancer: is it adequate to achieve a diagnosis in both sexes? An individual patient data meta-analysis.","authors":"Franz Sesti, Tiziana Feola, Pasquale Dolce, Valentina Guarnotta, Alessandro Veresani, Elia Guadagno, Filomena Bottiglieri, Maria Grazia Tarsitano, Andrea M Isidori, Annamaria Colao, Antongiulio Faggiano, Elisa Giannetta","doi":"10.1530/ETJ-24-0347","DOIUrl":"10.1530/ETJ-24-0347","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of medullary thyroid cancer (MTC) when basal calcitonin (CT) levels are <100 pg/mL remains a clinical challenge. The calcium stimulation test is a unique tool for stimulating CT. However, standardized and sex-specific cutoff values are lacking. Therefore, this study aimed to investigate whether the calcium stimulation test for CT is adequate for diagnosing MTC in both sexes and to identify sex-specific cutoff values.</p><p><strong>Methods: </strong>This was an individual patient data (IPD) meta-analysis. A literature search was performed using Scopus, PubMed, and Web of Science until September, 2024, to identify articles on the calcium stimulation test for diagnosing MTC.</p><p><strong>Results: </strong>A total of five studies involving 243 patients (148 females and 95 males) who underwent total thyroidectomy were included in this study. Before surgery, all patients underwent the calcium stimulation test with calcium gluconate (25 mg/kg) for CT assessed by chemiluminescence assay. In females, a global threshold of 162 pg/mL was identified, with a pooled sensitivity of 0.90 (95% confidence interval (95% CI): 0.79-0.97) and specificity of 0.66 (95% CI: 0.56-0.75). The pooled area under the curve (AUC) was 0.87 (95% CI: 0.76-0.97). In males, a global threshold of 562 pg/mL was identified, with a pooled sensitivity of 0.79 (95% CI: 0.60-0.92) and specificity of 0.89 (95% CI: 0.79-0.96). The pooled AUC was 0.94 (95% CI: 0.90-0.99).</p><p><strong>Conclusions: </strong>The calcium stimulation test for CT for the diagnosis of MTC showed better performance in males than in females, with a suggested cutoff value of 562 pg/mL in males.</p><p><strong>Significance statement: </strong>The management of indeterminate calcitonin (CT) values is still challenging in the early diagnosis of MTC, lacking general recommendations, which can help clinicians in these cases. This is the first IPD meta-analysis that underscores the sex-based disparity in the diagnostic accuracy of the calcium stimulation test for CT in suspected MTC cases, showing better performance in diagnosing MTC in male versus female patients, with a cutoff value of 562 pg/mL in male subjects. In the context of the limited literature, this paper provides added value for the clinical endocrine practitioner, suggesting the use of the calcium stimulation test in highly selected cases with indeterminate CT values (10-100 pg/mL) with a sex-oriented and personalized approach.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired thyroid hormone receptor signaling in anterior hypothalamic parvalbumin neurons causes bradycardia in male mice.","authors":"Beke Kolms, Riccardo Dore, Sarah C Sentis, Leonardo Vinicius Monteiro de Assis, Henrik Oster, Jens Mittag","doi":"10.1530/ETJ-25-0055","DOIUrl":"10.1530/ETJ-25-0055","url":null,"abstract":"<p><p>Thyroid hormone receptor α1 (TRα1) regulates body temperature and heart rate in humans and mice. In addition to its direct actions in target tissues, it also affects peripheral functions indirectly through the brain. While these central actions on peripheral tissues have been demonstrated for liver and brown fat, the consequences for cardiac functions are still enigmatic. Recently, a population of parvalbumin neurons has been discovered in the anterior hypothalamic area that depends on TRα1 for correct development and controls heart rate in a temperature-dependent manner. Here we test the hypothesis that not only developmental but also acute actions of TRα1 in hypothalamic parvalbumin neurons affect the central control of cardiovascular functions. We used an AAV-mediated stereotaxic approach to express a mutant TRα1R348C conditionally in hypothalamic parvalbumin cells, thus impairing TRα1 action specifically in these neurons. While this had no effect on metabolism or thermoregulation, using non-invasive radiotelemetry we observed a reduced heart rate both at 22°C and 30°C. Interestingly, heart rate was normalized when the animals were measured by ECG, which requires prior handling, suggesting that the impairment caused by the mutant TRα1 can be compensated in more stressful situations. Taken together, our data show that TRα1 signaling in hypothalamic parvalbumin neurons acutely affects the central control of heart rate, adding a novel mechanism to bradycardia in hypothyroidism. Furthermore, the data underline the importance of non-invasive recordings of in vivo functions in animal models with alterations in central thyroid hormone action.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomogram to predict the prognostic value of tumor deposits for patients with papillary thyroid carcinoma.","authors":"Jie Tan, Junna Ge, Zhigang Wei, Baihui Sun, Tingting Li, Zhicheng Zhang, Weisheng Chen, Jixiang Zheng, Jiayuan Zou, Ting Wang, Shi-Tong Yu, Shangtong Lei","doi":"10.1530/ETJ-24-0343","DOIUrl":"https://doi.org/10.1530/ETJ-24-0343","url":null,"abstract":"<p><strong>Background: </strong>Tumor deposits (TDs), nodules in the peritumoral adipose tissue with no architectural residue of lymph node, have previously been described in colorectal adenocarcinomas with poor prognosis. However, the significance of TD has not been fully investigated in patients with papillary thyroid carcinoma (PTC).</p><p><strong>Method: </strong>We retrospectively enrolled 541 patients undergoing surgery between 2015 and 2021. The patients were classified into two groups according to TD status (TD vs non-TD), and the clinicopathologic characteristics and disease-free survival (DFS) were compared. Associations of TD presence with other clinicopathologic factors were evaluated by logistic regression analysis. Univariate and multivariate Cox regression analyses were performed to determine the primary cohort's prognostic factors for DFS. A nomogram was constructed for clinicians as a quantitative tool for estimating DFS.</p><p><strong>Result: </strong>In our cohort, TD were identified in 16.1% of patients and had higher rate of aggressive features, including microscopic and gross extrathyroidal extension, invasion of the recurrent laryngeal nerve and esophagus, prevertebral fascia involvement or encasement of the carotid artery/internal jugular vein, extranodal extension, advanced clinical stage, tumor recurrence and distant metastasis (all P < 0.05). Univariate and multivariate Cox regression analyses confirmed TD as an independent prognostic factor for DFS, with a 2.501-fold increased risk of recurrence (P < 0.001). The nomogram, incorporating TD and other significant factors, demonstrated good discrimination and calibration (C-index = 0.79).</p><p><strong>Conclusion: </strong>The presence of TD was significantly associated with poor prognosis in PTC patients. TD showed promising efficacy as a potential prognostic indicator for PTC patients.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":"14 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mammalian acid chitinase promotes oncogenic properties of thyroid cancer cells through the JAK2/STAT3 pathway.","authors":"Zhiyuan Ma, Renmin Mu, Zhengxing Zhou, Zilai Hu, Mimi Shen, Chengli Lu, Hu Wang, Chengmin Zhang, Minglin Zhang, Zhiqiang Yi, Zilin Deng, Yingying Zhao, Jiaxing Zhu, Guorong Wen, Hai Jin, Jiaxing An, Biguang Tuo, Xuemei Liu, Taolang Li","doi":"10.1530/ETJ-24-0311","DOIUrl":"10.1530/ETJ-24-0311","url":null,"abstract":"<p><strong>Objective: </strong>Mammalian acid chitinase (AMCase; CHIA) has potential as a biomarker and drug target in the fields of medicine and pharmacology, and its role in inhibiting tumor growth and Th2 cell-mediated asthma-related inflammation has become a research hotspot. However, the role of CHIA in thyroid cancer is unclear.</p><p><strong>Methods: </strong>Tissue microarrays and thyroid cancer cell lines were used to detect CHIA expression and determine its clinical relevance. CHIA gene expression was altered in thyroid cancer cells to examine the effects of CHIA expression on the biological behavior of thyroid cancer cells, and the related molecular mechanisms involved were explored.</p><p><strong>Results: </strong>We first examined CHIA expression in a thyroid tissue microarray using immunohistochemistry. We found that CHIA was significantly upregulated in thyroid cancer tissues relative to paired thyroid cancer adjacent tissues. After correlation analysis, we found that upregulated CHIA expression correlated with the tumor-node-metastasis (TNM) stage of patients with thyroid cancer. Similarly, CHIA expression was significantly higher in the thyroid cancer cell lines BCPAP, TPC-1, KTC-1 and FTC133 than in the human normal thyroid epithelial cell line Nthy-ori-3-1. CHIA promotes proliferation, migration and invasion; inhibits thyroid cancer cell apoptosis; and regulates markers of proliferation and epithelial-mesenchymal transition. Mechanistically, CHIA activated the JAK2/STAT3 signaling pathway in thyroid cancer cells.</p><p><strong>Conclusions: </strong>CHIA upregulation promoted the proliferation, migration and invasion of thyroid cancer cells through JAK2/STAT3 signaling pathway activation. Therefore, CHIA could represent a potential new oncoprotein for patients with thyroid cancer.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of maternal thyroid peroxidase antibody exposure with children's emotional and behavioral problems.","authors":"Penggui Wu, Mengting Yang, Yuzhu Teng, Jiajun Ouyang, Wenjin Cai, Juan Tong, Guopeng Gao, Xiaoyan Wu, Yan Han, Shuangqin Yan, Fangbiao Tao, Kun Huang","doi":"10.1530/ETJ-24-0302","DOIUrl":"10.1530/ETJ-24-0302","url":null,"abstract":"<p><strong>Objective: </strong>Maternal thyroid peroxidase antibody (TPOAb) positivity has been associated with a variety of pregnancy complications and has potential neuropsychological developmental implications for the offspring. The aim of our study was to explore the effect of maternal TPOAb levels on emotional and behavioral problems in children.</p><p><strong>Design: </strong>The study was designed as a cohort study.</p><p><strong>Participants: </strong>Based on the Ma'anshan birth cohort in China, 2,464 mother-infant pairs were included in this study.</p><p><strong>Measurements: </strong>Repeated blood samples were collected from pregnant women, and TPOAb and FT4 were measured retrospectively by electrochemiluminescence immunoassay (ECLIA). The strengths and difficulties questionnaire was used to assess the emotional and behavioral problems of 4-year-old preschoolers.</p><p><strong>Results: </strong>After adjusting for potential confounders, maternal TPOAb positivity during the third trimester of pregnancy was found to be associated with an elevated risk of conduct problems in girls, with an odds ratio (OR) of 2.190 (95% confidence interval (CI): 1.137-4.219). Conversely, maternal TPOAb positivity in the first trimester was linked to a decreased incidence of prosocial behavior in boys, with an OR of 0.451 (95% CI: 0.237-0.861).</p><p><strong>Conclusions: </strong>Maternal TPOAb positivity during pregnancy may be associated with emotional and behavioral problems in preschool-aged children.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender impact on safety and efficacy in lenvatinib treated patients with radioiodine-refractory differentiated thyroid cancer (GISEL study).","authors":"Giulia Puliani, Marta Bianchini, Carlotta Giani, Laura Valerio, Alice Nervo, Giulia Sapuppo, Giorgio Grani, Cristina Dalmiglio, Simone De Leo, Rosa Lauretta, Marilda Mormando, Irene Terrenato, Stefania Zovato, Laura Fugazzola, Maria Grazia Castagna, Cosimo Durante, Gabriella Pellegriti, Emanuela Arvat, Rossella Elisei, Marialuisa Appetecchia","doi":"10.1530/ETJ-24-0386","DOIUrl":"10.1530/ETJ-24-0386","url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about sex differences in lenvatinib treatment safety and efficacy.</p><p><strong>Methods: </strong>Real-word retrospective Italian multicenter study enrolling patients with radioiodine-refractory differentiated thyroid cancer treated with lenvatinib.</p><p><strong>Results: </strong>A total of 138 patients (64 females) were included, with a median follow-up of 26 months (2-72). More men performed physical activities (34% vs 17%, P = 0.024). The frequency of smoking and alcohol consumption was higher in men (58% vs 33%, P = 0.003; 45% vs 17%, P = 0.001). We did not find sex differences in lenvatinib dose reduction due to adverse events (AEs) (78% females vs 85% males). Ninety-nine percent of patients developed at least one adverse event (AE), with no sex difference in their number and the time to first AE. Severe AEs occurred in 74% of males and 66% of females (P = 0.398), with a mean dose of 18.2 mg (±5.7), and a median time to the first serious AE of 9 weeks (1-154). Stomatitis/mucositis and hematological disorders were more frequent in females (48% vs 30%, P = 0.016; 17% vs 4%, P = 0.011). Gastrointestinal disorders were higher in males (15% vs 2%, P = 0.010). Eighty-seven patients interrupted lenvatinib due to AEs (median time: 3 months (0-48), mean dose: 17 mg ±5.5). Discontinuation occurred in 21 patients, five for severe AEs. No sex differences were found in progression-free survival, overall survival or disease control rate. Liver metastases were associated with disease progression (HR: 3.73, 95% CI: 1.06-13.12, P = 0.040) or death (HR: 4.82, 95% CI: 1.75-13.25, P = 0.002) only in females.</p><p><strong>Conclusion: </strong>Lenvatinib is effective in both sexes and exhibits a good safety profile, with a sex difference in the frequencies of some adverse events.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-dose versus low-dose block-and-replace treatment for a first episode of Graves' disease.","authors":"Arnaud Smolders, Aglaia Kyrilli, Stefan Matei Constantinescu, Bernard Corvilain, Chantal Daumerie, Maria-Cristina Burlacu","doi":"10.1530/ETJ-25-0039","DOIUrl":"10.1530/ETJ-25-0039","url":null,"abstract":"<p><strong>Objective: </strong>The optimal treatment with antithyroid drugs (ATDs) for a first episode of Graves' disease (GD) remains controversial.</p><p><strong>Methods: </strong>Retrospective, two academic centres study of newly diagnosed GD between 1990 and 2022, treated with ATD in block-and-replace (B+R) regimen for at least 12 months and followed up for at least 1 year after ATD discontinuation or until disease relapse. Sixty patients received high-dose B+R (HD) with fixed ATD dose maintained during the study, and 60 patients received low-dose B+R (LD) with lower ATD dose adjusted during the study.</p><p><strong>Results: </strong>Baseline characteristics were similar in both groups. The point-prevalence of euthyroidism was not different between HD and LD (38 vs 47%, P = 0.460 at 6 months, 69 vs 82%, P = 0.194 at 12 months, 70 vs 78%, P = 0.370 at 18 months, respectively). At 18 months, 27% HD vs 38% LD (P = 0.242) had thyroid eye disease. There were no differences in the number or type of ATD-related adverse events (AE) (no AE 73 vs 78%, P = 0.707). LD received mean lower ATD dose (15.3 ± 4.2 vs 30.0 ± 0.0 mg/day, P < 0.001) and lower levothyroxine dose (72.6 ± 16.7 vs 100.6 ± 24.5 μg/day, P < 0.001). After a first course of ATD, 63% of HD patients and 60% of LD patients relapsed (P = 0.707) after a median time (interquartile range) of 11.0 (18) vs 7.0 (19) months (P = 0.109).</p><p><strong>Conclusion: </strong>We observed similar relapse rates in patients with a first episode of GD receiving up to 50% less ATD and 30% less levothyroxine dose than high-dose B+R regimen.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticancer drug therapy for anaplastic thyroid cancer.","authors":"Naomi Kiyota, Taiji Koyama, Iwao Sugitani","doi":"10.1530/ETJ-24-0287","DOIUrl":"10.1530/ETJ-24-0287","url":null,"abstract":"<p><p>Anaplastic thyroid cancer is one of the rarest subtypes of thyroid cancer, accounting for only 1-2% of all thyroid cancer cases. It is also one of the most aggressive: prognosis remains dismal and the disease-specific mortality rate is close to 100%. This rarity has markedly limited the availability of prospective trial results, and no standard chemotherapeutic option for unresectable or metastatic anaplastic thyroid cancer has yet been established. Nevertheless, combination therapy with a BRAF inhibitor and MEK inhibitor has shown encouraging efficacy in patients with BRAF V600E-mutated anaplastic thyroid cancer. Other novel treatments such as immune checkpoint inhibitors have also shown promising results. Owing to these therapeutic advances, the prognosis of anaplastic thyroid cancer appears to be gradually improving. However, further development of novel treatments for this rare malignancy requires the development of substantial infrastructure for international collaborative study.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}