The Journal of clinical endocrinology and metabolism · 2026
Outcome of first-line chemotherapy for anaplastic thyroid cancer-a multicenter registry analysis.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Graf Katharina Elisabeth, Adam Pia, Megerle Felix, Machlah Yara Maria, Soll Dominik, Berr Christina M, Budde Ilka, Pfob Christian H, Käsmann Lukas, Fuß Carmina Teresa, Küppers Sarah, Corradini Stefanie, Mai Knut, Schott Matthias, Sandner Benjamin, Führer Dagmar, Spitzweg Christine, Fassnacht Martin, Brandenburg Tim, Koehler Viktoria Florentine, Kroiss Matthias, German Study Group for Rare Malignant Tumors of the Thyroid and Parathyroid glands
Аннотация
CONTEXT: Prognosis of anaplastic thyroid cancer (ATC) remains poor. In the absence of immediately actionable molecular alterations, guidelines recommend multimodal therapy including radiotherapy and cytotoxic chemotherapy, but optimal regimens are not established. Many centers in Germany have adopted carboplatin/paclitaxel (CP), with or without radiotherapy, as a preferred first-line approach.
OBJECTIVE: This study aims to compare the outcome of patients treated first-line with CP ± radiotherapy vs other cytotoxic chemotherapy regimens in ATC.
DESIGN: Retrospective multicenter registry study in Germany.
SETTING AND PATIENTS: 158 adults with histologically confirmed ATC treated with first-line cytotoxic chemotherapy at 7 German tertiary centers (2000-2024).
MAIN OUTCOME MEASURES: Progression-free survival (PFS) and overall survival (OS) were compared with Kaplan-Meier and log-rank tests; a Cox proportional hazard model was used to identify risk factors.
RESULTS: 97 patients received first-line CP, and 61 received other chemotherapy. PFS (102 vs 89 days; log-rank P = .23) and OS (278 vs 295 days; P = .50) did not differ between CP and other regimens. Complete response occurred in 13% with CP and 8% with other chemotherapy (P = .46). In multivariable analyses, age ≥65 years, lymph node metastasis, and distant metastasis were associated with higher mortality risk. Surgery was associated with a lower mortality risk. CP was not associated with improved OS. The outcome of second-line treatment was not different for chemotherapy vs kinase inhibition ± immunotherapy.
CONCLUSION: In this registry study, CP showed no survival benefit in ATC; outcomes depended on disease burden and resectability, underscoring the need for rapid molecular diagnostics. Chemotherapy may serve as a bridging strategy.
OBJECTIVE: This study aims to compare the outcome of patients treated first-line with CP ± radiotherapy vs other cytotoxic chemotherapy regimens in ATC.
DESIGN: Retrospective multicenter registry study in Germany.
SETTING AND PATIENTS: 158 adults with histologically confirmed ATC treated with first-line cytotoxic chemotherapy at 7 German tertiary centers (2000-2024).
MAIN OUTCOME MEASURES: Progression-free survival (PFS) and overall survival (OS) were compared with Kaplan-Meier and log-rank tests; a Cox proportional hazard model was used to identify risk factors.
RESULTS: 97 patients received first-line CP, and 61 received other chemotherapy. PFS (102 vs 89 days; log-rank P = .23) and OS (278 vs 295 days; P = .50) did not differ between CP and other regimens. Complete response occurred in 13% with CP and 8% with other chemotherapy (P = .46). In multivariable analyses, age ≥65 years, lymph node metastasis, and distant metastasis were associated with higher mortality risk. Surgery was associated with a lower mortality risk. CP was not associated with improved OS. The outcome of second-line treatment was not different for chemotherapy vs kinase inhibition ± immunotherapy.
CONCLUSION: In this registry study, CP showed no survival benefit in ATC; outcomes depended on disease burden and resectability, underscoring the need for rapid molecular diagnostics. Chemotherapy may serve as a bridging strategy.