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J.Jpn. Surg. Soc.. 124(1): 32-37, 2023


Feature topic

RECENT ADVANCES IN THE TREATMENT OF ANAPLASTIC THYROID CANCER

Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan

Ken-ichi Ito, Hiroki Morikawa, Masatsugu Amitani, Tadafumi Shimizu, Takaaki Oba, Tokiko Ito, Toshiharu Kanai

Anaplastic thyroid cancer is relatively uncommon; however, it accounts for around half of all thyroid cancer deaths. It is an orphan disease with highly aggressive behavior, and improvement in prognosis has not been achieved for decades. In Japan, the Anaplastic Thyroid Carcinoma Research Consortium has created a large database on this unique orphan disease, and analysis of the clinical picture of this virulent cancer has progressed. In addition, physician-initiated trials demonstrated the feasibility of weekly paclitaxel administration. Meanwhile, overseas, the use of molecularly targeted drugs based on BRAF, RET/PTC, and NTRK mutations and tumor mutation burden, which were introduced with recent advances in precision oncology, has shown marked improvement in the prognosis of anaplastic thyroid cancer patients and these therapies have already been included in guidelines. Unfortunately, not all these molecularly targeted drugs have been approved in Japan. Thus, there is a large gap between the current situation in Japan and in other countries. The prognosis of anaplastic thyroid cancer, for which no improvement in treatment outcome has been achieved for a long time, is finally improving with advances in precision oncology. Hopefully, a system will be established in Japan as soon as possible to treat this virulent disease based on precision oncology.


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