Endocrine Abstracts

Introduction : The incidence of thyroid carcinoma is increasing worldwide, so much so that it is ranked 3rd cancer in women in Algeria; Fortunately, the incidence of refractory cancers remains stable. The latter represent a real therapeutic challenger. We report the experience of our service.

Material and method : Between 2018 and 2024, 545 differentiated thyroid carcinomas and 10 anaplastic carcinomas were consulted, 28 of which were classified as refractory carcinomas (5%). The refractory carcinomas appear progressive according to the RECIST criteria were treated with anti-tyrosine kinase type sorafenib, i.e. 9 patients treated (32%), including an anaplastic carcinoma. Divided between 3 women and 6 men with an average age of 59 years. All patients were initially classified at high risk of recurrence according to ATA2015 and all presented distant metastases (mainly bone and lung). The average treatment dose was 600 mg and the main side effect observed was high blood pressure. Two serious side effects were observed: tracheal hemorrhage and ischemic stroke. Tumor regression was observed in 2 patients but unfortunately the treatment was stopped in one of them due to the appearance of a serious side effect; lesion stability in 3 patients; progression of the disease leading to the cessation of treatment in 4 patients and a rebound phenomenon in one patient who decided to stop his treatment in view of the side effects.

Discussion and conclusion: Refractory thyroid cancers are rare but responsible for the majority of deaths linked to this cancer. The use of kinase inhibitors has made it possible to improve the outcome of these patients. On the other hand, in addition to the cost being high, they have a notable influence, responsible for side effects that often alter the quality of life, for a response that is not always present. Due to the complexity of these treatments, these patients are best managed by multidisciplinary groups.