Combined targeted therapy and immunotherapy in anaplastic thyroid carcinoma with distant metastasis: A case report

doi:10.12998/wjcc.v10.i12.3849

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Apr 26, 2022; 10(12): 3849-3855
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3849

Combined targeted therapy and immunotherapy in anaplastic thyroid carcinoma with distant metastasis: A case report

Dong-Xu Ma, Xiu-Ping Ding, Chi Zhang, Peng Shi

Dong-Xu Ma, Chi Zhang, Peng Shi, Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China

Dong-Xu Ma, Department of Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong Province, China

Xiu-Ping Ding, Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China

Author contributions: Ma DX wrote this paper; Shi P joined the surgery and revised the paper; Zhang C collect the information and follow up of the patient; Ding XP joined the targeted therapy and immunotherapy.

Informed consent statement: Informed consent was obtained from the patient for this case report and accompanying images.

Conflict-of-interest statement: All authors have no relevant conflicts of interest with the manuscript.

CARE Checklist (2016) statement: The authors adopted the guidelines of the CARE checklist (2016) during the preparation of this manuscript and have compared the modifications.

Corresponding author: Peng Shi, PhD, Chief Doctor, Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University, No. 324 Jing 5 Road, Jinan 250021, Shandong Province, China. shipengwmm@126.com

Received: July 26, 2021
Peer-review started: July 26, 2021
First decision: October 22, 2021
Revised: December 2, 2021
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: April 26, 2022
Processing time: 268 Days and 23.3 Hours

Abstract

BACKGROUND

Anaplastic thyroid carcinoma (ATC), also called undifferentiated thyroid cancer, is the least common but most aggressive and deadly thyroid gland malignancy of all thyroid cancers[1]. It has poor prognosis, and is the leading cause of death from malignant thyroid tumors. The one-year survival rate is 20%, with a median overall survival (OS) of only 5 mo[2]. The aim of this report is to provide our experience in the diagnosis and treatment of ATC.

CASE SUMMARY

A patient with a thyroid mass underwent surgical treatment after developing symptoms of hoarseness. The resected tumor was pathologically diagnosed as ATC. Imaging examination revealed organ and lymph node metastasis. After multiple cycles of chemotherapy and local radiotherapy, the metastases were not relieved and gradually increased in size and new metastases appeared. The patient immediately received immunotherapy combined with targeted therapy. During treatment, immune-related adverse reactions occurred, which were improved after symptomatic treatment, and tolerated by the patient. The OS of the patient was more than 30 mo after immunotherapy combined with targeted therapy.

CONCLUSION

For metastatic ATC, surgical treatment, radiotherapy and chemotherapy have no significant effect on remission of the disease. However, immunotherapy has made a breakthrough in the treatment of ATC.

Keywords: Anaplastic thyroid carcinoma; Distant metastasis; Nivolumab; Cabozantinib; Targeted therapy; Immunotherapy; Case report

Core Tip: Anaplastic thyroid carcinoma (ATC) is a rare thyroid malignancy, it is extremely aggressive and has a very low survival rate. Immunotherapy combined with targeted therapy results in prolonged survival and good quality of life. We summarize the relevant clinical data and review the literature. This report aims to provide clinical experience in the treatment of an ATC patient by immunotherapy combined with targeted therapy.