ECE2021 Audio Eposter Presentations Late Breaking (114 abstracts)
Relapsed Differentiated Thyroid Cancer, clinical presentation, treatment, and prognostic factors (ERUDIT Study)
Marcel Sambo 1 , Elena Navarro González 2 , Javier Aller Pardo 3 , Sonsoles Guadalix Iglesias 4 , Carles Zafón Llopis 5 , Cintia González Blanco 6 , Javier Santamaría Sandi 7 , Marcelino Gómez Balaguer 8 , Manel Puig Domingo 9 , Juan C. Galofré Ferrater 10 , Iñaki Argüelles Jiménez 11 , Rita Santos 12 , Marta Llanos Muñoz 13 , Juan Antonio Vallejo Casas 14 , Virginia Pubul Núñez 15 , Guillermo Crespo Herrero 16 , Ángel Segura Huerta 17 , Miguel Navarro Martín 18 , Pablo Gajate Borau 19 , Javier Valdivia Bautista 20 , Beatriz Castelo Fernández 21 , Carlos López López 22 , María J. Villanueva Silva 23 , Lorenzo Orcajo 24 & Julio Rodríguez-Villanueva García 24
1Gregorio Marañón Hospital, Madrid, Spain; 2Hospital Virgen Del Rocio, Sevilla, Spain; 3Puerta de Hierro Majadahonda University Hospital, Majadahonda, Spain; 4Hospital 12 De Octubre, Madrid, Spain; 5Hospital Universitari Vall d’Hebron, Barcelona, Spain; 6Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; 7Hospital Universitario Cruces, Barakaldo, Spain; 8Doctor Peset University Hospital, València, Spain; 9Hospital Germans Trias i Pujol, Badalona, Spain; 10Clinica Universidad de Navarra, Pamplona, Spain; 11Hospital Universitari Son Espases, Palma, Spain; 12Institute of Oncology Francisco Gentil, Lisboa, Portugal; 13Hospital Universitario de Canarias, San Cristóbal de La Laguna, Spain; 14Hospital Reina Sofía, Córdoba, Spain; 15Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; 16Hospital Universitario de Burgos, Burgos, Spain; 17Hospital Universitario y Politécnico de La Fe, València, Spain; 18Hospital Universitario de Salamanca, Salamanca, Spain; 19Hospital Ramón y Cajal, Madrid, Spain; 20University Hospital Complex of Granada, Granada, Spain; 21La Paz University Hospital, Madrid, Spain; 22Marqués de Valdecilla University Hospital, Santander, Spain; 23Álvaro Cunqueiro Hospital, Vigo, Spain; 24Eisai Farmaceutica SA, Oncology, Madrid, Spain
Advanced differentiated thyroid carcinoma (aDTC), herein defined as locally unresectable and/or metastatic, is one of the most common late-stage endocrine neoplasias. However, available data about its natural history are limited. ERUDIT is a multicenter, observational, retrospective study of patients diagnosed with aDTC in Spain and Portugal. The study describes its natural history from the initial diagnosis until the advanced stages, focusing on specific characteristics of this subpopulation, its treatment, response patterns, and medical specialties involved in its management. The objective of this communication is to describe the diagnostic demographics and clinical characteristics of relapsing DTC patients, the efficacy of rescue therapies used, and the prognostic factors associated to disease evolution. Clinical records from patients ≥18 y-o diagnosed with aDTC (including poorly differentiated DTC) with first evidence of advanced disease documented between January 2007 and August 2017, were retrospectively reviewed until death or lost to follow-up. 213 aDTC patients were identified in 23 sites with median age at initial DTC diagnosis 63 y-o and 59% being females. Of these, 46% progressed or relapsed to aDTC (87% metastatic, being lung in 41% of cases) after receiving initial treatment (surgery ± 131radioiodine [RAI]) for their early DTC (eDTC). Median (95% CI) relapse/progression-free survival [(RP)FS] and overall survival (OS) from the initial treatment were 2.3 (1.8–2.9) years and 10.4 (8.1–16.0) years, respectively. Notably, significant OS differences (log-rank P<0.0001) were seen according to surgical outcome, favouring R0/R1 resections compared to R2. Post-relapse rescue therapies, when indicated, were mainly RAI (57%) and surgery (13%). Specifically, 23% of the patients treated with RAI received up to 3 courses with median dose of 150 mCi each and cumulative dose of 620mCi. Persistent structural disease was frequently reported after RAI (average 15% after three doses). Initial R2 surgical outcome, receiving <600 mCi, not receiving any RAI or requiring stimulation with hrTSH, and resulting in incomplete biochemical/structural response to it, were all negative prognostic factors for eDTC to relapse to aDTC. Endocrinology was the leading medical specialty responsible for patient monitoring (63%), while two thirds of the patients were evaluated by multidisciplinary committees. Almost half of this cohort become aDTC tumours after relapsing from previously treated eDTC with median [(RP)FS] of 2.3 years while 57% being still RAI-treatable. From this group, yet 15% showed persistent disease after three RAI doses among other poor prognostic factors. This suggests identifying early unfavorable course in some DTC patients is maybe possible from initial stages.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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