Thyroid Gland Follicular Carcinoma

P1/2, N=263, Recruiting, Salubris Biotherapeutics Inc | N=149 --> 263

Clinical and histological features of MSO should be assessed for the postoperative treatment decisions. TSH suppression and thyroglobulin level measurements are necessary for patient follow-up.

P2, N=63, Active, not recruiting, National Cancer Institute (NCI)

P1, N=11, Recruiting, Osaka University | Trial completion date: Sep 2024 --> Sep 2025 | Trial primary completion date: Mar 2024 --> Mar 2025

P2, N=126, Recruiting, 3D Medicines (Sichuan) Co., Ltd. | N=200 --> 126 | Trial completion date: Apr 2024 --> Apr 2028 | Trial primary completion date: Apr 2024 --> Aug 2027

DICER1 and PTEN FNAs reveal many cytologic similarities. DICER1 patients are younger, and PTEN patients had multinodular disease. Awareness of these genetic cohorts can identify patients at risk for thyroid cancer.

SCC of the breast with spindle cell and sarcomatoid features is rare. The diagnosis of such tumors requires exclusion of tumors with similar histological morphologies.

ThyroSeq v3 effectively stratifies the ROM in indeterminate thyroid nodules based on specific genetic alterations, guiding appropriate surgical management. Notably, the BRAFV600E/high-risk group and RAS-like groups exhibited ROM of 100% and 77.5%, respectively, with promising predictive accuracy (PPV of 78.2% and NPV of 75.9%).

P3, N=201, Completed, Suzhou Zelgen Biopharmaceuticals Co.,Ltd | Active, not recruiting --> Completed | Trial completion date: Jul 2024 --> Jul 2023 | Trial primary completion date: Jun 2024 --> Jul 2023

Intraperitoneal nodal FDCS is extremely rare, and occasionally, it can lead to postoperative recurrence and progression. It is crucial to differentiate neoplastic lymph node enlargement around the pancreatic head from nodal FDCS.

DICER1-altered thyroid lesions occurred frequently in young females and FNAs show RAS-like cytomorphology including crowded, mixed macro-/microfollicular pattern, and bland nuclear features. On resection, DICER1-altered thyroid lesions include benign (50%), low-risk lesions (30%), or high-risk malignancies (20%).

The diagnosis of Cowden syndrome can be made with a combination of major and minor criteria: any two major criteria with or without a minor criterion; one major and one minor criterion; or three minor criteria. Patients who meet the diagnostic criteria for Cowden syndrome should undergo genetic screening.

Poorly differentiated thyroid carcinomas have a high case fatality rate (up to 31%). Eighty-five % of the patients who succumb to the disease have distant metastasis. Even though under-represented in literature, evidence-based management of these aggressive tumors can help personalize the treatment for optimal outcomes.

P=N/A, N=50, Recruiting, National Taiwan University Hospital | Not yet recruiting --> Recruiting

See also the graphical abstract(Fig. 1).

P2, N=27, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: Jan 2024 --> Sep 2024 | Trial primary completion date: Jan 2024 --> Sep 2024

P1, N=8, Completed, Memorial Sloan Kettering Cancer Center | Active, not recruiting --> Completed | Trial completion date: Dec 2024 --> Sep 2023

PTC was the most common histologic type of TC for which genetic profiling was performed in Japan, followed by ATC. Since the most common targetable mutation is the BRAF mutation, practical application of BRAF-targeted therapy can be an important treatment option for Japanese patients with TC.

The presentation of EBV+IFDCS with pronounced granulomatous changes is rare. This morphological variant poses a high risk of misdiagnosis, frequently leading to confusion with other granulomatous diseases. Accurate diagnosis necessitates a comprehensive analysis, integrating immunohistochemistry and in situ hybridization. The case presented here is instrumental in raising awareness and understanding of EBV+IFDCS, with the goal of reducing misdiagnoses and unrecognized cases.

P2, N=34, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: Jan 2024 --> Jan 2025

P2, N=30, Recruiting, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) | Trial primary completion date: Feb 2024 --> Feb 2025

This study represents an initial and ongoing effort to investigate the efficacy of molecular testing in the assessment of malignancy risk and prevention of unnecessary surgeries. Our small sample size is due to both molecular testing not being routinely used in our practice and the significant number of cases lost to follow-up. Nevertheless, our findings suggest that molecular "very likely benign" and "low-moderate ROM" assessments are good predictors of a benign surgical result.

Our study found no significant difference in the AUCs of MPTX1 and MPTX2. While NPV showed some improvement between versions, PPV decreased with the increased proportion of false positive cases. Of note, while many of the false positive cases in both test versions correctly picked up neoplasia, the shortcomings in discrimination between malignant and benign neoplasia can trigger unnecessary surgery.

Alone and in combination with ThyraMIR, ThyGeNEXT displayed high SN in our cohort, although SP and NPV were quite low as compared to the Interpace's published performance (SP 98%, NPV 99%). All ThyGeNEXT false positive cases displayed RAS mutations which cannot distinguish between benign and malignant nodules, thus the low SP. Though using the combined test increased NPV to 50%, the testing still missed one malignancy, thus leading to a low NPV.

Our patient is the first published case of Cowden syndrome, associated with multifocal pulmonary carcinoids. Besides multiple endocrine neoplasia type 1, we propose Cowden syndrome as another hereditary condition predisposing to multiple pulmonary tumorlets and carcinoid tumours.

The highest rate of bone metastases was found in patients with poorly differentiated, oncocytic, medullary, follicular, and papillary cancer, respectively. The results obtained in this study reveal the necessity and importance of bone metastasis evaluation in patients with thyroid cancer.

However, despite the merits of these discoveries, we acknowledge that 5hmC currently cannot segregate minimally invasive from widely invasive tumors, although 5hmC levels were lower in wi-FPTCs. Further research is needed to explore the potential clinical implications of 5hmC in thyroid tumors.

To our knowledge, this is one of the first 2D global transcriptional mappings of FTC using this platform to date. Invasive FTC clones develop in a stepwise fashion and display significant dysregulation of genes associated with the ECM and EMT - thus highlighting important molecular crosstalk for further investigations.

In this population, 42% have received standard lenvatinib and 13% have received genotype-matched targeted therapy... In our real-world study, NGS testing revealed high rates of Tier I-II actionable genomic alterations in PTC (77%), MTC (81%), and ATC (31%). NGS-identified BRAF V600E mutations in ATC has a high rate of triggering matched targeted therapy. NGS identification of RET-mutated MTC facilitated use of RET inhibitors.

Two lesions of the lung and mesentery were surgically resected. The mass in the mesentery was pathologically diagnosed as metastatic WDTC.

Although high CD74 expression has been reported in papillary and anaplastic thyroid carcinomas, it has not been analyzed in follicular thyroid carcinomas. Furthermore, the heterogeneity of CD74 expression in thyroid tumors has not yet been reported. The CD74-positive subpopulation identified in this study may be useful in predicting invasion of follicular thyroid carcinomas.

The receiver operating characteristic (ROC) analysis for the more aggressive FTC subtype differential marker suggests value in estimating RASSF1A and AKAP9 expression, with their area under curve (AUC), specificity, and sensitivity at 0.743 (95% CI: 0.548-0.938), 82.2%, and 66.7%; for RASSF1A, and 0.848 (95% CI: 0.698-0.998), 54.8%, and 100%, for AKAP9. Our research gives new insight into the basis of the aggressiveness and progression of thyroid cancers, and provides information on potential differential markers that may improve preoperative diagnosis.

Increasing tumor invasiveness and worsening prognosis in FTC based on the WHO classification and TERT promoter mutation results were positively correlated with US features that indicate malignant probability according to both K-TIRADS and ACR-TIRADS.

Employing the currently proposed cut-off values, false-positive FNA-CT results may be observed in benign/malignant TNs with coexisting diffuse CCH. FNA-CT must therefore be cautiously used in the diagnostic approach for patients with TNs and a slightly increased basal or stimulated serum CT concentration in order to avoid unnecessary surgery.

The total cost for workup of previously benign nodules was $285,454. Conclusions Repeat FNA biopsies did not provide an additional diagnostic value in the evaluation of benign thyroid nodules, and often led to unwarranted follow-up procedures and significantly increased health care cost.

This is the first study in Colombia (TIROSEC) to our knowledge that integrates molecular and histopathologic profiles enriching our local comprehension and knowledge of PTC. The identification of target mutations such as BRAF, RET and NTRK fusions holds the potential to guide targeted therapies for tumor recurrence and predict aggressive behavior.

EphB3 is expressed in the majority of PTC, but less so in benign follicular nodules. EphB3 expression in fine needle aspiration cytology (FNAC) specimens can be used as a diagnostic tool to differentiate thyroid cancer from other follicular lesions in its differential diagnosis, especially AUS/FLUS and PTC.

P=N/A, N=230, Recruiting, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University | Not yet recruiting --> Recruiting

The incidence of PTC/MTC has been increasing over the past 30 years. The etiology of PTC/MTC forms is still unknown, and although this simultaneous occurrence could be only a coincidence, we cannot exclude the hypothesis of a shared genetic origin.

An important consideration is the distinction of primary disease from metastatic malignancy. Genetic disorders including those caused by germline mutations of the FOXL2, GNAS, DICER1, STK11 and MEN1 genes can present with primary endocrine neoplasms of the female reproductive tract.

P2, N=115, Active, not recruiting, Fudan University | Trial completion date: Dec 2023 --> Jun 2024 | Trial primary completion date: Apr 2023 --> Dec 2023

Afirma XA improved risk stratification of thyroid disease with a high risk of malignancy in Afirma GSC suspicious nodules. A negative Afirma XA result, however, should not be used as a rule-out test.