This protocol addresses anaplastic thyroid cancer presenting at stage IVC in which molecular profiling of the thyroid tumor has detected an NTRK fusion or a RET fusion.
The combination of stage IVC disease and the presence of a fusion alteration — NTRK or RET — in the tumor establishes the eligibility and direction for this treatment approach. The specific fusion type detected guides agent selection.
The recommended approach involves initiating a targeted inhibitor directed at the fusion identified in the tumor — a TRK inhibitor pathway for NTRK-positive cases, or a RET inhibitor pathway for RET-positive cases.
Full agent selection, clinical trial options, and the complete management algorithm are available in the structured protocol below.
DOI: 10.1089/thy.2020.0944
In NTRK or RET fusion ATC patients with stage IVC disease, we suggest initiation of a TRK inhibitor (either larotrectinib or entrectinib) or RET inhibitor (either selpercatinib or pralsetinib), preferably in a clinical trial, if available.
All thyroid cancer patients achieved a response (four PR and one CR), but it is unclear whether any of these were ATCs.
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