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Predictors of radioiodine (RAI)-avidity restoration for NTRK fusion-positive RAI-resistant metastatic thyroid cancers.

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European thyroid journal 📖 저널 OA 100% 2022: 16/16 OA 2023: 20/20 OA 2024: 23/23 OA 2025: 40/40 OA 2026: 12/12 OA 2022~2026 2024 Vol.13(3)
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Syed AR, Gorana A, Nohr E, Yuan XK, Amin MASc P, Ghaznavi S

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[CONTEXT] Two-thirds of metastatic differentiated thyroid cancer (DTC) patients have radioiodine (RAI)-resistant disease, resulting in poor prognosis and high mortality.

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APA Syed AR, Gorana A, et al. (2024). Predictors of radioiodine (RAI)-avidity restoration for NTRK fusion-positive RAI-resistant metastatic thyroid cancers.. European thyroid journal, 13(3). https://doi.org/10.1530/ETJ-23-0227
MLA Syed AR, et al.. "Predictors of radioiodine (RAI)-avidity restoration for NTRK fusion-positive RAI-resistant metastatic thyroid cancers.." European thyroid journal, vol. 13, no. 3, 2024.
PMID 38642578 ↗
DOI 10.1530/ETJ-23-0227

Abstract

[CONTEXT] Two-thirds of metastatic differentiated thyroid cancer (DTC) patients have radioiodine (RAI)-resistant disease, resulting in poor prognosis and high mortality. For rare NTRK and RET fusion-positive metastatic, RAI-resistant thyroid cancers, variable success of re-induction of RAI avidity during treatment with NTRK or RET inhibitors has been reported.

[CASE PRESENTATION AND RESULTS] We report two cases with RAI-resistant lung metastases treated with larotrectinib: an 83-year-old male presenting with an ETV6::NTRK3 fusion-positive tumor with the TERT promoter mutation c.-124C>T, and a 31-year-old female presenting with a TPR::NTRK1 fusion-positive tumor (and negative for TERT promoter mutation). Post larotrectinib treatment, diagnostic I-123 whole body scan revealed unsuccessful RAI-uptake re-induction in the TERT-positive tumor, with a thyroid differentiation score (TDS) of -0.287. In contrast, the TERT-negative tumor exhibited successful I-131 reuptake with a TDS of -0.060.

[CONCLUSION] As observed for RAI-resistance associated with concurrent TERT and BRAF mutations, the co-occurrence of TERT mutations and NTRK fusions may also contribute to re-sensitization failure.

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