Feasibility of Short-Term Redifferentiation in Patients with Radioactive Iodine-Refractory Metastatic Thyroid Cancer

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Johannes von Hinten - , Augsburg University (Author)
  • Oliver Viering - , Augsburg University (Author)
  • Ralph A. Bundschuh - , Department of Nuclear Medicine, Augsburg University (Author)
  • Feyza Cagliyan - , Augsburg University, Marmara University (Author)
  • Hermann Wengenmair - , Augsburg University (Author)
  • Christian H. Pfob - , Augsburg University (Author)
  • James Nagarajah - , Radboud University Nijmegen, Roentgeninstitut Düsseldorf (Author)
  • Constantin Lapa - , Augsburg University (Author)
  • Malte Kircher - , Augsburg University (Author)

Abstract

Radioactive iodine-refractory thyroid cancer (TC) has a poor prognosis, and restoring iodine uptake is a major therapeutic goal. Recent studies have used tyrosine kinase inhibitors (TKIs) for 3-6 wk to achieve redifferentiation, but preclinical data suggest that maximal effects occur within 8-12 d. Methods: In this retrospective study, 8 patients with metastatic radioactive iodine-refractory TC received trametinib plus dabrafenib (for BRAF-mutated disease) or trametinib alone (for BRAF wild-type disease) for 10 d. Iodine uptake was assessed by 123I-scintigraphy; responders received high-dose radioactive iodine therapy, and nonresponders continued TKIs for another 10 d. Results: Two patients (both with BRAF wild-type disease) achieved successful iodine uptake restoration with significant thyroglobulin reduction after radioactive iodine therapy. Extending TKI treatment to 21 d did not yield further benefit. Conclusion: Our pilot study supports preclinical findings that maximal restoration of iodine uptake is achieved after only 10 d of TKI therapy, reducing toxicity and treatment costs. Longer treatment did not provide any additional benefit. Larger prospective trials are needed to confirm these findings.

Details

Original languageEnglish
Pages (from-to)1192-1196
Number of pages5
JournalJournal of nuclear medicine : official publication, Society of Nuclear Medicine
Volume66
Issue number8
Publication statusPublished - 1 Aug 2025
Peer-reviewedYes

External IDs

PubMed 40473458

Keywords

Sustainable Development Goals

Keywords

  • kinase inhibition, metastatic differentiated thyroid carcinoma, radioiodine-refractory thyroid cancer, redifferentiation