Anaplastic Thyroid Cancer
ICD-10 C73 · ICD-11 2D10.3

Stage IVC or Unresectable IVB Anaplastic Thyroid Cancer with BRAFV600E Mutation — Treatment When Radiation Is Declined

Clinical Scenario

This protocol applies to patients with anaplastic thyroid cancer (ATC) presenting at stage IVC or unresectable stage IVB who carry the BRAFV600E mutation and have declined radiation therapy. This is a first-line treatment setting.

Key Factors Present
Stage IVC Unresectable Stage IVB BRAFV600E Mutation Radiation Therapy Declined
Treatment Direction
For BRAFV600E-mutated ATC at this stage, a targeted BRAF/MEK inhibitor combination is recommended over other systemic therapies when available. The complete regimen, sequencing, and full evidence summary are available in the structured protocol.
Treatment goal: Tumor regression — partial or complete response.
Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1089/thy.2020.0944

In BRAFV600E-mutated IVC and in unresectable IVB ATC patients who decline radiation therapy, initiation of BRAF/MEK inhibitors (dabrafenib plus trametinib) is recommended over other systemic therapies if available.

In particular, dabrafenib (150 mg twice daily) combined with trametinib (2 mg daily) was studied in a prospective, nonrandomized clinical trial of patients with BRAFV600E-mutated ATC.

BRAF-directed therapy can induce prompt and impressive tumor regression in these patients, and therefore, use of these drugs in stage IVC patients is recommended in BRAFV600E-mutated patients.

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