Overview on Differentiated Thyroid Cancer (DTC)

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EP: 1.Overview on Differentiated Thyroid Cancer (DTC)

EP: 2.Diagnosing DTC: Clinical Workup and Molecular Testing

EP: 3.Patient Scenario 1: RR DTC Managed With Frontline Lenvatinib

EP: 4.Practical Considerations for Managing RR DTC With Systemic Therapy

EP: 5.Defining Radioiodine-Refractory Differentiated Thyroid Cancer

EP: 6.RR DTC: Active Surveillance vs Initiating Systemic Therapy

EP: 7.Overview of Available Treatment Options for RR DTC

EP: 8.Quality of Life and Real-World Data in Patients With RR DTC

EP: 9.RR DTC: Managing Adverse Events With Dose Reductions or Holds

EP: 10.Patient Scenario 2: Second-Line Management of RR DTC With Cabozantinib

EP: 11.Clinical Data Behind Second-Line Therapy in RR DTC

EP: 12.Practical Considerations for Utilizing Second-Line Therapy in RR DTC

EP: 13.Patient Scenario 3: Treating RR DTC With an Identified RET Fusion

EP: 14.Optimizing Use of RET Inhibitors in Patients With RR DTC

EP: 15.Sequencing Throughout Multiple Lines of Therapy in RR DTC

Transcript:

Lori J. Wirth, MD: Hello, and welcome to this OncLive Peer Exchange®titled “Treatment Approaches and Sequencing Strategies in Differentiated Thyroid Cancer.” I am Dr Lori Wirth, associate professor of medicine at Harvard Medical School [in Boston, Massachusetts] and medical director of the Center for Head-Neck Cancers. I am joined today by a panel of good friends and experts in thyroid cancers. I would like to welcome my esteemed fellow panelists to introduce themselves. Frank, why don’t we start with you?

Francis P. Worden, MD: Hi, my name is Frank Worden. I am a clinical professor of medicine at the Rogel Cancer Center at the University of Michigan [in Ann Arbor, Michigan]. I specialize in head-neck cancers and endocrine cancers including thyroid, neuroendocrine tumors, and renal cancers.

Lori J. Wirth, MD: Dr Cohen.

Ezra Cohen, MD, FRCPSC, FASCO: Thanks, Lori. I’m Ezra Cohen from the University of California, San Diego [in San Diego, California]. I’m a professor of medicine and my interest is head, neck and thyroid cancers as well.

Lori J. Wirth, MD: And Dr Brose.

Marcia S. Brose, MD, PhD: Hi, I’m Marcia Brose. I am a professor at the Sidney Kimmel Cancer Center in Philadelphia, [Pennsylvania,]and the Thomas Jefferson University Medical School, and my specialty is thyroid cancer and also personalized therapy.

Lori J. Wirth, MD: Welcome, everyone. Thank you for joining us for today’s program. We’re going to be discussing a number of recent updates in the treatment of differentiated thyroid cancer, [which] we might call DTC during the program, presented at key conferences in 2022. We’ll discuss the data in the context of guidelines, the treatment landscape, and the impact on clinical practice. So let’s get started with our first topic. First,…a brief overview of the epidemiology of thyroid cancer. Overall what we’ve been experiencing in the last 10 years is kind of interesting because the incidence of thyroid cancers was rapidly increasing in our population until we recognized that we were overdiagnosing cases of low-grade cancers that were never going to cause any illness. That epidemic of overdiagnosis has been addressed recently, and now we’re seeing a decrease in the numbers of thyroid cancers being diagnosed. So in this past year, we expect that approximately 43,800 cancers will be diagnosed in the US [United States]. There’s an interesting female-to-male ratio where we see 3 times as many women being diagnosed with thyroid cancer than men. I don’t know that anybody really understands quite why that is.

In terms of deaths, we see a relatively low number of deaths; only approximately 3,300 deaths will be seen in the US due to thyroid cancer this year. Thyroid cancer in women is the 7th most common cancer. It’s less common in men, of course. In terms of the different histologic diagnoses, the vast majority of thyroid cancers are differentiated thyroid cancer, and approximately 97% of cases are differentiated thyroid cancer. That’s the focus of our program today. Now the 5-year overall survival rate of DTC is 98%. Two-thirds of patients will be diagnosed with local regionally advanced disease only. Those patients in general do very well, but when patients do develop distant metastatic disease, their median overall survival is only about 5 years. Those are the patients who ultimately may die of their thyroid cancer, and that’s really what we’re going to be focusing on today.

Transcript edited for clarity.