Specialists in the Thyroid Cancer Center at Dana-Farber/Brigham and Women’s Cancer Center are providing targeted treatments to improve outcomes for patients with advanced and aggressive thyroid cancers in the new Thyroid Cancer 360 Program.
“While the majority of thyroid cancer patients are cured with standard therapy, up to 10 percent of patients go on to develop refractory disease that is incurable. Some patients – such as those with poorly differentiated and anaplastic thyroid cancer – present with extremely aggressive disease associated with a very poor prognosis,” says Jochen Lorch, MD, director of the Thyroid Cancer Center at Dana-Farber/Brigham and Women’s Cancer Center. “This personalized cancer treatment program is designed to help identify the most appropriate targeted therapies for these patients as their cancer evolves, and to develop new therapeutic approaches in the treatment of advanced and aggressive thyroid cancers.”
The Thyroid Cancer 360 Program is using cutting-edge technologies to extract information from individual tumors in the most comprehensive way possible. “We are leveraging the unique research environment at Dana-Farber Cancer Institute and Brigham and Women’s Hospital , with Harvard University colleagues, to obtain as much information as possible from these challenging cases with the goal to use this information to personalize treatment at a new level.”
A wide range of advanced technologies are used and include:
- Next-generation and whole exome sequencing;
- Analyses of circulating tumor cells and cell-free DNA;
- Immunotherapy screening via a novel microfluidic chamber system;
- Drug screening program using fresh tumor tissue to determine susceptibility of patients’ tumors to a broad range of innovative therapies.
“We have performed these in-depth analyses and shown how powerful testing can be,” says Dr. Lorch. “Now it is time to integrate this into clinical care.”
First Immunotherapy Trial for Thyroid Cancer
Based on findings in the lab, the Thyroid Cancer Center developed a research study which recently began enrolling patients. It is the first immunotherapy trial specifically designed for patients with thyroid cancer – a Phase 2 study of nivolumab plus ipilimumab in radioactive iodine (RAI) refractory, aggressive thyroid cancer with exploratory cohorts in medullary and anaplastic thyroid cancer. The study is enrolling 54 patients. The goal is tumor response (PR+CR). When accessible, fresh tissue biopsies will be obtained to assess multiple immunologic parameters which include PD-1, PDL-1 expression, and T-cell infiltration, as well as testing of live cells to grow tumor spheroids and provide in vitro testing of immune therapy drugs.
“The goal of this study is to test the hypothesis that combined CTLA-4 and PD-1 inhibition is able to induce immunologic response in RAI refractory thyroid cancer, resulting in tumor cell death and tumor shrinkage,” says Dr. Lorch, who is the principal investigator of the study.
Additional Studies and Prior Results
Specialists in the Thyroid Cancer Center are offering several studies of targeted therapies in thyroid cancer, including an ongoing Phase 2 clinical trial of MLN0128, an mTOR kinase inhibitor, in anaplastic thyroid cancer. Results of the team’s previous Phase 2 study of the mTOR inhibitor everolimus in metastatic anaplastic thyroid cancer were published in 2014. A patient in that study demonstrated a near-complete response for 18 months before her cancer progressed.
“We expect that our prior results will support the use of targeted therapies in the treatment of patients with anaplastic thyroid cancer in the future and encourage continued research of novel immunologic approaches in thyroid cancer,” says Dr. Lorch.
For more information regarding these studies, please call (617) 632-3090.