Survival in Response to Multimodal Therapy in Anaplastic Thyroid Cancer

Naiyarat Prasongsook, Aditi Kumar, Ashish Chintakuntlawar, Robert L. Foote, Jan Kasperbauer, Julian R Molina, Yolanda Isabel Garces, Daniel Ma, Michelle A.Neben Wittich, Joseph Rubin, Ronald Richardson, John Morris, Ian D Hay, Vahab Fatourechi, Bryan McIver, Mabel Ryder, Geoffrey Thompson, Clive Grant, Melanie Richards, Thomas J. SeboMichael Rivera, Vera Jean Suman, Sarah M. Jenkins, Robert Christian Smallridge, Keith C. Bible

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Context: Historical outcomes in anaplastic thyroid cancer (ATC) have been dismal.

Objective: To determine whether an initial intensive multimodal therapy (MMT) is associated with improved ATC survival.

Design: MMT was offered to all patients with newly diagnosed ATC treated at the Mayo Clinic from 2003 through 2015; MMT vs care with palliative intent (PI) was individualized considering clinical status and patient preferences. Outcomes were retrospectively analyzed by American Joint Committee on Cancer stage and treatments compared with patient cohort data from 1949 through 1999.

Patients: Forty-eight patients (60% male; median age, 62 years); 18 treated with PI, 30 with MMT.

Main Outcome Measure: Overall survival (OS) and progression-free survival determined by Kaplan-Meier method.

Results: Median OS and 1-year survival for the later cohort were 9 months [95% confidence interval (CI), 4 to 22 months] and 42% (95% CI, 28% to 56%) vs 3 months and 10% for the earlier cohort. Median OS was 21 months compared with 3.9 months in the pooled MMT vs PI groups for the later cohort [hazard ratio (HR), 0.32; P = 0.0006]. Among only patients in the later cohort who had stage IVB disease, median OS was 22.4 vs 4 months (HR, 0.12; 95% CI, 0.03 to 0.44; P = 0.0001), with 68% vs 0% alive at 1 year (MMT vs PI). Among patients with stage IVC cancer, OS did not differ by therapy.

Conclusion: MMT appears to convey longer survival in ATC among patients with stage IVA/B disease.

Original languageEnglish (US)
Pages (from-to)4506-4514
Number of pages9
JournalThe Journal of clinical endocrinology and metabolism
Volume102
Issue number12
DOIs
StatePublished - Dec 1 2017

Fingerprint

Hazards
Survival
Palliative Care
Confidence Intervals
Therapeutics
Anaplastic Thyroid Carcinoma
Patient Preference
Disease-Free Survival
Neoplasms
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Survival in Response to Multimodal Therapy in Anaplastic Thyroid Cancer. / Prasongsook, Naiyarat; Kumar, Aditi; Chintakuntlawar, Ashish; Foote, Robert L.; Kasperbauer, Jan; Molina, Julian R; Garces, Yolanda Isabel; Ma, Daniel; Wittich, Michelle A.Neben; Rubin, Joseph; Richardson, Ronald; Morris, John; Hay, Ian D; Fatourechi, Vahab; McIver, Bryan; Ryder, Mabel; Thompson, Geoffrey; Grant, Clive; Richards, Melanie; Sebo, Thomas J.; Rivera, Michael; Suman, Vera Jean; Jenkins, Sarah M.; Smallridge, Robert Christian; Bible, Keith C.

In: The Journal of clinical endocrinology and metabolism, Vol. 102, No. 12, 01.12.2017, p. 4506-4514.

Research output: Contribution to journalArticle

Prasongsook, N, Kumar, A, Chintakuntlawar, A, Foote, RL, Kasperbauer, J, Molina, JR, Garces, YI, Ma, D, Wittich, MAN, Rubin, J, Richardson, R, Morris, J, Hay, ID, Fatourechi, V, McIver, B, Ryder, M, Thompson, G, Grant, C, Richards, M, Sebo, TJ, Rivera, M, Suman, VJ, Jenkins, SM, Smallridge, RC & Bible, KC 2017, 'Survival in Response to Multimodal Therapy in Anaplastic Thyroid Cancer', The Journal of clinical endocrinology and metabolism, vol. 102, no. 12, pp. 4506-4514. https://doi.org/10.1210/jc.2017-01180
Prasongsook, Naiyarat ; Kumar, Aditi ; Chintakuntlawar, Ashish ; Foote, Robert L. ; Kasperbauer, Jan ; Molina, Julian R ; Garces, Yolanda Isabel ; Ma, Daniel ; Wittich, Michelle A.Neben ; Rubin, Joseph ; Richardson, Ronald ; Morris, John ; Hay, Ian D ; Fatourechi, Vahab ; McIver, Bryan ; Ryder, Mabel ; Thompson, Geoffrey ; Grant, Clive ; Richards, Melanie ; Sebo, Thomas J. ; Rivera, Michael ; Suman, Vera Jean ; Jenkins, Sarah M. ; Smallridge, Robert Christian ; Bible, Keith C. / Survival in Response to Multimodal Therapy in Anaplastic Thyroid Cancer. In: The Journal of clinical endocrinology and metabolism. 2017 ; Vol. 102, No. 12. pp. 4506-4514.
@article{27ba66c66d1546fca94aed6ee1faf860,
title = "Survival in Response to Multimodal Therapy in Anaplastic Thyroid Cancer",
abstract = "Context: Historical outcomes in anaplastic thyroid cancer (ATC) have been dismal.Objective: To determine whether an initial intensive multimodal therapy (MMT) is associated with improved ATC survival.Design: MMT was offered to all patients with newly diagnosed ATC treated at the Mayo Clinic from 2003 through 2015; MMT vs care with palliative intent (PI) was individualized considering clinical status and patient preferences. Outcomes were retrospectively analyzed by American Joint Committee on Cancer stage and treatments compared with patient cohort data from 1949 through 1999.Patients: Forty-eight patients (60{\%} male; median age, 62 years); 18 treated with PI, 30 with MMT.Main Outcome Measure: Overall survival (OS) and progression-free survival determined by Kaplan-Meier method.Results: Median OS and 1-year survival for the later cohort were 9 months [95{\%} confidence interval (CI), 4 to 22 months] and 42{\%} (95{\%} CI, 28{\%} to 56{\%}) vs 3 months and 10{\%} for the earlier cohort. Median OS was 21 months compared with 3.9 months in the pooled MMT vs PI groups for the later cohort [hazard ratio (HR), 0.32; P = 0.0006]. Among only patients in the later cohort who had stage IVB disease, median OS was 22.4 vs 4 months (HR, 0.12; 95{\%} CI, 0.03 to 0.44; P = 0.0001), with 68{\%} vs 0{\%} alive at 1 year (MMT vs PI). Among patients with stage IVC cancer, OS did not differ by therapy.Conclusion: MMT appears to convey longer survival in ATC among patients with stage IVA/B disease.",
author = "Naiyarat Prasongsook and Aditi Kumar and Ashish Chintakuntlawar and Foote, {Robert L.} and Jan Kasperbauer and Molina, {Julian R} and Garces, {Yolanda Isabel} and Daniel Ma and Wittich, {Michelle A.Neben} and Joseph Rubin and Ronald Richardson and John Morris and Hay, {Ian D} and Vahab Fatourechi and Bryan McIver and Mabel Ryder and Geoffrey Thompson and Clive Grant and Melanie Richards and Sebo, {Thomas J.} and Michael Rivera and Suman, {Vera Jean} and Jenkins, {Sarah M.} and Smallridge, {Robert Christian} and Bible, {Keith C.}",
year = "2017",
month = "12",
day = "1",
doi = "10.1210/jc.2017-01180",
language = "English (US)",
volume = "102",
pages = "4506--4514",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "12",

}

TY - JOUR

T1 - Survival in Response to Multimodal Therapy in Anaplastic Thyroid Cancer

AU - Prasongsook, Naiyarat

AU - Kumar, Aditi

AU - Chintakuntlawar, Ashish

AU - Foote, Robert L.

AU - Kasperbauer, Jan

AU - Molina, Julian R

AU - Garces, Yolanda Isabel

AU - Ma, Daniel

AU - Wittich, Michelle A.Neben

AU - Rubin, Joseph

AU - Richardson, Ronald

AU - Morris, John

AU - Hay, Ian D

AU - Fatourechi, Vahab

AU - McIver, Bryan

AU - Ryder, Mabel

AU - Thompson, Geoffrey

AU - Grant, Clive

AU - Richards, Melanie

AU - Sebo, Thomas J.

AU - Rivera, Michael

AU - Suman, Vera Jean

AU - Jenkins, Sarah M.

AU - Smallridge, Robert Christian

AU - Bible, Keith C.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Context: Historical outcomes in anaplastic thyroid cancer (ATC) have been dismal.Objective: To determine whether an initial intensive multimodal therapy (MMT) is associated with improved ATC survival.Design: MMT was offered to all patients with newly diagnosed ATC treated at the Mayo Clinic from 2003 through 2015; MMT vs care with palliative intent (PI) was individualized considering clinical status and patient preferences. Outcomes were retrospectively analyzed by American Joint Committee on Cancer stage and treatments compared with patient cohort data from 1949 through 1999.Patients: Forty-eight patients (60% male; median age, 62 years); 18 treated with PI, 30 with MMT.Main Outcome Measure: Overall survival (OS) and progression-free survival determined by Kaplan-Meier method.Results: Median OS and 1-year survival for the later cohort were 9 months [95% confidence interval (CI), 4 to 22 months] and 42% (95% CI, 28% to 56%) vs 3 months and 10% for the earlier cohort. Median OS was 21 months compared with 3.9 months in the pooled MMT vs PI groups for the later cohort [hazard ratio (HR), 0.32; P = 0.0006]. Among only patients in the later cohort who had stage IVB disease, median OS was 22.4 vs 4 months (HR, 0.12; 95% CI, 0.03 to 0.44; P = 0.0001), with 68% vs 0% alive at 1 year (MMT vs PI). Among patients with stage IVC cancer, OS did not differ by therapy.Conclusion: MMT appears to convey longer survival in ATC among patients with stage IVA/B disease.

AB - Context: Historical outcomes in anaplastic thyroid cancer (ATC) have been dismal.Objective: To determine whether an initial intensive multimodal therapy (MMT) is associated with improved ATC survival.Design: MMT was offered to all patients with newly diagnosed ATC treated at the Mayo Clinic from 2003 through 2015; MMT vs care with palliative intent (PI) was individualized considering clinical status and patient preferences. Outcomes were retrospectively analyzed by American Joint Committee on Cancer stage and treatments compared with patient cohort data from 1949 through 1999.Patients: Forty-eight patients (60% male; median age, 62 years); 18 treated with PI, 30 with MMT.Main Outcome Measure: Overall survival (OS) and progression-free survival determined by Kaplan-Meier method.Results: Median OS and 1-year survival for the later cohort were 9 months [95% confidence interval (CI), 4 to 22 months] and 42% (95% CI, 28% to 56%) vs 3 months and 10% for the earlier cohort. Median OS was 21 months compared with 3.9 months in the pooled MMT vs PI groups for the later cohort [hazard ratio (HR), 0.32; P = 0.0006]. Among only patients in the later cohort who had stage IVB disease, median OS was 22.4 vs 4 months (HR, 0.12; 95% CI, 0.03 to 0.44; P = 0.0001), with 68% vs 0% alive at 1 year (MMT vs PI). Among patients with stage IVC cancer, OS did not differ by therapy.Conclusion: MMT appears to convey longer survival in ATC among patients with stage IVA/B disease.

UR - http://www.scopus.com/inward/record.url?scp=85038234081&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038234081&partnerID=8YFLogxK

U2 - 10.1210/jc.2017-01180

DO - 10.1210/jc.2017-01180

M3 - Article

C2 - 29029287

AN - SCOPUS:85038234081

VL - 102

SP - 4506

EP - 4514

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 12

ER -