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CASE REPORT article

Front. Endocrinol.
Sec. Cancer Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1389294

NEOADJUVANT TREATMENT WITH LENVATINIB AND PEMBROLIZUMAB IN A BRAF V600E MUTATED ANAPLASTIC THYROID CANCER: CASE REPORT

Provisionally accepted
Daniele Barbaro Daniele Barbaro 1*Raffaella Forleo Raffaella Forleo 1Mariaantonietta Profilo Mariaantonietta Profilo 1Paola Lapi Paola Lapi 1Carlotta Giani Carlotta Giani 1Liborio Torregrossa Liborio Torregrossa 2Elisabetta Macerola Elisabetta Macerola 2Gabriele Materazzi Gabriele Materazzi 2
  • 1 UO Endocrinologia ASL nord ovest Toscana, Livorno, Italy
  • 2 University of Pisa, Pisa, Tuscany, Italy

The final, formatted version of the article will be published soon.

    Background: Tirosin kinase inhibitors (TKIs) and immunotherapy have been proposed for advanced metastatic anaplastic thyroid cancer (ATC). We report a case of BRAF V600E-mutated ATC in which Lenvatinib (L) plus Pemprolizumab ( P) enabled neoadjuvant treatment.Case presentation: A male patient, aged 65 years, presented with a rapidly enlarging left laterocervical mass. Fine needle aspiration was suggestive of ATC. Surgical consultation excluded radical surgery .While awaiting the molecular profile analysis and considering the fast evolution of the disease, treatment with L and P was started. L was started at a dose of 14 mg daily and P was started at the standard regimen (200 mg every three weeks). After one month computerized tomography showed a reduction in the mass with almost complete colliquative degeneration and the carotid artery wall was free from infiltration .Radical surgery was performed. The histology confirmed papillary thyroid cancer (PTC) in the left lobe and ATC with extensive necrosis in left latero-cervical lymph-node metastasis. The margins were free of tumours (R0). BRAF V600E mutation was present in both PTC and in ATC. At the one year follow-up, the patient was free of disease.Conclusion: L and P in combination also appear to be effective as neoadjuvant treatment in BRAF V600E mutated ATC. Their use could be undertaken every time the opportunity presents for the complete resection of the cancer as soon as is possible. The middle dose of 14mg of L seemed to be well tolerated and effective.

    Keywords: anaplastic thyroid cancer, Lenvatinib, Pembrolizumab, BRAF mutation V600, Neoadjuvant

    Received: 21 Feb 2024; Accepted: 14 Jun 2024.

    Copyright: © 2024 Barbaro, Forleo, Profilo, Lapi, Giani, Torregrossa, Macerola and Materazzi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Daniele Barbaro, UO Endocrinologia ASL nord ovest Toscana, Livorno, Italy

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