With more and more drugs aimed at specific molecular alterations in thyroid cancer becoming available, the approach to this tumor has become more precise, which has resulted in an increase in the expectations of the patients and an improvement in their quality of life. However, there is a dramatic fact - "more than 95% of patients do not have to option of a molecular diagnosis," says Dr. Enrique Grande, head of the Medical Oncology Service at MD Anderson Cancer Center Madrid, on the occasion of the World Thyroid Cancer Day, held on September 24.
In his opinion, the availability of drugs targeting specific mutations known to be responsible for the growth and spread of these tumors should go hand in hand with the search for these alterations. "If we do not identify the patients with these molecular alterations, we cannot know whether the patient might benefit from these treatments or not, that is, if the patient has less of a chance," explains Dr. Grande, who was also the moderator of oral presentations on thyroid cancer at the European Society for Medical Oncology (ESMO) Congress, which took place recently.
Dr. Grande states that, for example, "one in five patients with metastatic or locally advanced thyroid cancer could benefit from RET inhibitors", a class of drugs specifically targeting this mutation and which have been the subject of some of the presentations at ESMO.
As these drugs target a very specific alteration, they give a “very high response rate, around 70%, which means that they significantly reduce the size of the tumor and, as a result, they are extremely effective in controlling symptoms derived from the tumor and therefore, the patient's quality of life”, Dr. Grande points out. This is important because, as the doctor explains, most of these patients "develop large metastases in the lungs causing symptoms like fatigue, phlegm, recurrent lung infections, bloody sputum and chest pain".
Now, thanks to much more precise medicine and the incorporation of targeted therapies into the arsenal of treatments in metastatic thyroid cancer, we can reduce these symptoms and greatly improve the quality of life of the patients. Of course, “to be able to offer them targeted therapy, it is important to make a good molecular diagnosis of these patients,” reiterates the head of the Medical Oncology Service at MD Anderson Madrid.
In addition, the center uses a multidisciplinary approach in which surgical oncologists, medical oncologists, otorhinolaryngologists, endocrinologists, pathologists, nutritionists and radiologists work together from the moment the diagnosis is made. "We evaluate the patient jointly and, subsequently, we offer the best that each of us as specialists can contribute at each step", says Dr. Grande.
Woman under 50 years of age - the most common profile of a patient with thyroid cancer
Every year, five women and two men per 100,000 inhabitants in Spain are diagnosed with thyroid cancer. Furthermore, most of these diagnoses correspond to people under 50 years of age. A situation the Spanish Association of Thyroid Cancer (AECAT) has been working on for more than 15 years with a clear goal - to deal with the health and social needs of these patients and their families.
For this reason, on the occasion of World Thyroid Cancer Day, Arantxa Saez, president of the Spanish Association of Thyroid Cancer (AECAT), shares Dr. Grande's concern that all these patients should have access to genomic testing. "It is a step that would dramatically change the treatment and monitoring of thyroid cancer," says Ms. Saez, who adds that these tests are "a vital tool for both patients and professionals and even for the health services, which would save costs by avoid some unnecessary approaches”.
Furthermore, the president of AECAT insists on the need for reference units and multidisciplinary teams of experts in the approach to thyroid cancer. "The probability of patients suffering sequelae is substantially lower if the patient is operated on by a specialized team. I believe that all patients should be treated by specialized teams and experts to obtain the best results”.