Long-lasting Complete Remission Following Immunotherapy With Anti-PD1 Plus Anti-CTLA4 in a Polymetastatic Patient With NRAS (Q16R) Mutated Anaplastic Thyroid Carcinoma.

BACKGROUND/AIM: Anaplastic thyroid cancer (ATC) is a rare and aggressive malignancy. Its prognosis is poor, particularly in patients with distant metastasis. Treatment of ATC Is mostly palliative. In this report, we present the case of a patient affected by NRAS Q16R mutated, polymetastatic and multi-treated ATC, who showed complete remission of the disease after the use of an anti-PD1 and anti-CTLA4 doublet.

CASE REPORT: We present the clinical case of an 82-year-old patient affected by polymetastatic anaplastic thyroid carcinoma carrying NRAS (Q16R) mutation, treated with surgery, radiotherapy and chemotherapy. Complete and long-lasting disease response was induced to the patient after immunotherapy anti PD1 plus anti CTLA4 (pembrolizumab + ipilimumab).

CONCLUSION: The combination of pembrolizumab plus ipilimumab may represent a therapeutic strategy in patients with NRAS (Q16R) mutated anaplastic thyroid cancer.