 |
|
Presence of gene mutation helps guide thyroid cancer treatment
September 06, 2007A specific gene mutation may be useful in predicting the level of aggression of thyroid cancer and help guide treatment options and follow-up care, according to new study findings.
The mutation, called BRAF V600E, is a genetic alteration in the BRAF oncogene, a modified gene believed to cause cancer. The new research is reported in the September issue of the "Annals of Surgery."
Past studies have shown that the mutation frequently occurs in the most common type of thyroid cancer, conventional papillary thyroid cancer or PTC, but this is the largest study to classify thyroid cancer by cell structure subtype and to show that the mutation is significantly associated with cancer recurrence after treatment, according to the research team.
The findings come at an important time as both the incidence of thyroid cancer and the number of patients who die from the disease is increasing in the United States. More than 33,000 new cases of thyroid cancer are expected to be diagnosed in 2007, according to the National Cancer Institute.
Most patients diagnosed with thyroid cancer have small, localized PTC but may receive aggressive treatment because their risk of recurrence and death cannot be reliably predicted prior to surgery, the study authors noted.
"There is a pressing need to identify a reliable preoperative approach for stratifying patients according to risk of thyroid cancer recurrence and death," said lead author Electron Kebebew, MD, who is an assistant professor of surgery and endocrine surgeon at the University of California, San Francisco and a research scientist with the UCSF Comprehensive Cancer Center.
"This study shows that a particular mutation is a reliable indicator, and testing for the mutation may be useful for selecting initial therapy, determining the need for and extent of surgery, as well as the need for ongoing monitoring and follow-up care," he emphasized.
In the study, the researchers examined tumor samples from 314 patients with thyroid cancer (245 with conventional PTC, 73 with follicular thyroid cancer and 29 with the follicular variant of PTC) to determine the presence of BRAF V600E and its association with factors such as tumor size, tumor stage, and patient outcome.
They found the mutation in 51 percent of patients with conventional PTC, in 1 percent of patients with follicular thyroid cancer, and in 24.1 percent of patients with follicular variant PTC.
In conventional PTC and follicular variant PTC, the mutation was significantly associated with older age, larger tumor size, and recurrent and persistent disease. These patients also showed a trend toward a higher rate of cancer formation in the lymph node due to metastasis (the transfer of tumor cells from one organ or part of the body to another organ or part) and higher stage cancer.
In patients with conventional PTC, the mutation was associated with older age, lymph node and other metastasis, and was an independent risk factor for recurrent and persistent disease. Median follow-up time of all patients in this study was six years.
Kebebew explained that identification of the mutation in patients with thyroid cancer could be very useful in a variety of ways. For example, patients with the mutation may be candidates for a more aggressive approach to surgery, such as removing the central lymph node along with the diseased thyroid, to avoid the possibility of metastasis following surgery. BRAF V600E testing could also be useful for deciding between low- or high-dose radioiodine ablation therapy.
"Advances in molecular biology techniques have improved our understanding of the genetic changes in cells that lead to the formation of cancer and have provided opportunities for identifying disease biomarkers like this mutation," added Kebebew. "It is critical to continue the drive to discover reliable biomarkers so we can better identify, treat and cure cancer."
The study was funded by the Robert Wood Johnson Foundation, the American Cancer Society Research Scholars Grant, Hellman Family Grant, the University of California Cancer Research Committee and the National Institutes of Health.
Study co-investigators were Julie Weng, BS; Juergen Bauer, MD; Gustavo Ranvier, MD; Orlo Clark, MD; Quan-Yang Duh, MD; Daniel Shibru, MD; Boris Bastian, MD, and Ann Griffin, PhD, all of UCSF.
UCSF is a leading university that advances health worldwide by conducting advanced biomedical research, educating graduate students in the life sciences and health professions, and providing complex patient care.
The University of California, San Francisco
The findings come at an important time as both the incidence of thyroid cancer and the number of patients who die from the disease is increasing in the United States. More than 33,000 new cases of thyroid cancer are expected to be diagnosed in 2007, according to the National Cancer Institute.
Most patients diagnosed with thyroid cancer have small, localized PTC but may receive aggressive treatment because their risk of recurrence and death cannot be reliably predicted prior to surgery, the study authors noted.
"There is a pressing need to identify a reliable preoperative approach for stratifying patients according to risk of thyroid cancer recurrence and death," said lead author Electron Kebebew, MD, who is an assistant professor of surgery and endocrine surgeon at the University of California, San Francisco and a research scientist with the UCSF Comprehensive Cancer Center.
"This study shows that a particular mutation is a reliable indicator, and testing for the mutation may be useful for selecting initial therapy, determining the need for and extent of surgery, as well as the need for ongoing monitoring and follow-up care," he emphasized.
In the study, the researchers examined tumor samples from 314 patients with thyroid cancer (245 with conventional PTC, 73 with follicular thyroid cancer and 29 with the follicular variant of PTC) to determine the presence of BRAF V600E and its association with factors such as tumor size, tumor stage, and patient outcome.
They found the mutation in 51 percent of patients with conventional PTC, in 1 percent of patients with follicular thyroid cancer, and in 24.1 percent of patients with follicular variant PTC.
In conventional PTC and follicular variant PTC, the mutation was significantly associated with older age, larger tumor size, and recurrent and persistent disease. These patients also showed a trend toward a higher rate of cancer formation in the lymph node due to metastasis (the transfer of tumor cells from one organ or part of the body to another organ or part) and higher stage cancer.
In patients with conventional PTC, the mutation was associated with older age, lymph node and other metastasis, and was an independent risk factor for recurrent and persistent disease. Median follow-up time of all patients in this study was six years.
Kebebew explained that identification of the mutation in patients with thyroid cancer could be very useful in a variety of ways. For example, patients with the mutation may be candidates for a more aggressive approach to surgery, such as removing the central lymph node along with the diseased thyroid, to avoid the possibility of metastasis following surgery. BRAF V600E testing could also be useful for deciding between low- or high-dose radioiodine ablation therapy.
"Advances in molecular biology techniques have improved our understanding of the genetic changes in cells that lead to the formation of cancer and have provided opportunities for identifying disease biomarkers like this mutation," added Kebebew. "It is critical to continue the drive to discover reliable biomarkers so we can better identify, treat and cure cancer."
The study was funded by the Robert Wood Johnson Foundation, the American Cancer Society Research Scholars Grant, Hellman Family Grant, the University of California Cancer Research Committee and the National Institutes of Health.
Study co-investigators were Julie Weng, BS; Juergen Bauer, MD; Gustavo Ranvier, MD; Orlo Clark, MD; Quan-Yang Duh, MD; Daniel Shibru, MD; Boris Bastian, MD, and Ann Griffin, PhD, all of UCSF.
UCSF is a leading university that advances health worldwide by conducting advanced biomedical research, educating graduate students in the life sciences and health professions, and providing complex patient care.
The University of California, San Francisco
Thyroid Cancer Current Events and Thyroid Cancer News RSSResearchers discover atomic bomb effect results in adult-onset thyroid cancer
Radiation from the atomic bomb blasts in Hiroshima and Nagasaki, Japan, in 1945, likely rearranged chromosomes in some survivors who later developed papillary thyroid cancer as adults, according to Japanese researchers.
Scans spot hidden tumors in rare cancer syndrome
Researchers at Dana-Farber Cancer Institute report that full-body PET/CT scanning detected unsuspected, treatable tumors in 3 of 15 patients with Li-Fraumeni syndrome (LFS), a rare genetic cancer syndrome for which no screening tests have been recommended.
Mailman School PH study finds increase in thyroid diseases risk from exposure at Chernobyl
Persons exposed to radioactive fallout from the Chernobyl accident as children and adolescents have an increased risk of follicular adenoma or benign tumor of the thyroid gland, according to researchers at Columbia University Mailman School of Public Health.
Scientists solve structure of gene regulator that plays key role in cancer
Scientists at The Wistar Institute have collaborated on a major advance in understanding a gene regulator that contributes to some of the deadliest cancers in humans. The culmination of 10 years' work, their research paves the way for the development of new cancer therapies.
Role of Thyroid Hormones in Slumber Under Investigation at Rutgers-Camden
While the thyroid has long been linked to metabolism, cutting-edge research underway at Rutgers University-Camden is investigating the possibility that thyroid hormones have an important role in sleep regulation.
Ethanol injection helps manage bone metastasis in thyroid cancer patients
Percutaneous ethanol injection (PEI)-an injection of ethanol (alcohol) through the skin directly into a bone tumor to kill cancer cells-may be a valuable ancillary treatment for thyroid cancer patients whose cancer has spread to the bone. Japanese researchers announced these findings during the 54th Annual Meeting of SNM, the world's largest society for molecular imaging and nuclear medicine.
Hepatitis C increases risk of non-Hodgkin lymphoma
Hepatitis C infection is associated with an increased risk of non-Hodgkin lymphoma (malignancy involving lymphatic tissue) of 20 percent to 30 percent, and a three-fold increase in the risk of another type of lymphoma, according to a study in the May 9 issue of JAMA.
Lung cancer rates higher among female nonsmokers than previously
Not all lung cancer is due to a lifetime of smoking cigarettes. Sometimes the diagnosis is a mystery, and the stigma surrounding the disease makes it hard for patients to talk about.
Thyroid cancer discovery points to new treatments, prevention
The actions of a mutated protein in cells linked to thyroid cancer have been uncovered by researchers at Queen's University.
Enzyme inhibitor produces stable disease in patients with advanced solid cell cancers
Preliminary trials of a MEK enzyme inhibitor have shown that it is capable of producing long-lasting stable disease in patients with advanced solid cancers. Tests showed that the drug inhibited key targets in the patients' tumours, and now it is being tested in phase II clinical trials.
More Thyroid Cancer Current Events and Thyroid Cancer News Articles
 | Thyroid Cancer: A Guide for Patients by D. Van Nostrand, G. Bloom, L. Wartofsky This book is a valuable and extensive source of information about thyroid cancer and is specifically written for the patient with thyroid cancer. However, family and friends of patients who have thyroid cancer will also find this book useful. The book discusses a wide spectrum of aspects about thyroid nodules and cancer. It is discusses the basics of the thyroid gland, the evaluation of... |
 | Thyroid Cancer Thyroid Cancer describes all current diagnostic techniques, including FDG-PET and MRI. In recent years these modalities have documented hitherto hidden radioiodine-negative metastases, thus improving surgical therapy. The whole gamut of treatment, including surgery, radioiodine therapy, percutaneous radiation therapy and medical management, is covered. In some 10% of differentiated thyroid... |
 | The Thyroid, Cancer and You by A. Wolfe "I have been a registered nurse for over 30 years, and I found this book to be very informative. It is written in an easy style, which makes it a must read for anyone facing thyroid disease. This is a beautifully written, revolutionary approach to understanding and dealing with a frightening diagnosis." Marguerite Lorenzo, R.N. Upon her diagnosis of Thyroid Cancer, Ms. Wolfe spent a great... |
 | Quick FACTS Thyroid Cancer (Quickfacts) by American Cancer Society What people need to know-right from the start-about their Thyroid cancer More than 1.3 million Americans will be diagnosed with various forms of cancer this year. They, their families, and their caregivers will all be seeking information about their specific cancer type. This guide from the experts at the American Cancer Society gives them what they need to know, right from the... |
 | Management of Thyroid Cancer and Related Nodular Disease by I. Ross McDougall This is a single-authored, authoritative, readable volume covering all aspects of thyroid cancer. The text is supplemented with many illustrations including pathology, thyroid and whole-body scans, ultrasounds and other nuclear medicine and radiological studies and highlights important questions that patients should ask their physicians, indicating the topics the physician should cover. The... |
 | Essentials of Thyroid Cancer Management (Cancer Treatment and Research) This volume outlines patient care from diagnosis through various treatments for thyroid cancer patients. It serves as a state-of-the-art reference for clinicians providing comprehensive information on the scope of this disease, including surgery, nuclear medicine treatments, recurrence and metastases. Reference information is included for both physicians and thyroid cancer... |
 | Thyroid Cancer by Alan Elias M.D. Thyroid cancer is a relatively uncommon cancer although its incidence is increasing particularly among women. Because of the slow pace of spread of differentiated thyroid cancers a one-size fits all approach to the management of patients with this cancer is to be avoided. In this brief outline of the various types of thyroid cancer and their treatment the author has attempted to provide the... |
 | Practical Management of Thyroid Cancer: A Multidisciplinary Approach Written by a multidisciplinary team of experts involved in the development of standards and guidelines for its management in the USA, UK, Europe and Asia, the book contains succinct and knowledgeable summaries of the management of thyroid cancer. Every chapter describes a different aspect of care, and provides clear and detailed information about caring for patients with this group of tumors. ... |
 | Thyroid Diseases, Conditions, Autoimmunity and Cancers by James M. Lowrance There are many diseases that affect thyroid function, including those that cause hypothyroidism, hyperthyroidism, thyroid swelling (goiter), tumors in the gland (nodules) and thyroid cancer.This 6,065 word e-book looks at these conditions of thyroid dysfunction and the diseases that cause them including thyroid autoimmunity. ... |
 | Thyroid Cancer: A Comprehensive Guide to Clinical Management This massive revision of the highly acclaimed first edition presents a wealth of new information and insights on every aspect of the etiology, pathogenesis, diagnosis, initial treatment, and long-term management of all varieties of thyroid cancer. Paramount is a thorough treatment of the nuclear medical aspects of diagnosing and managing the thyroid cancer patient. This includes extensive... |
| © 2008 BrightSurf.com |