Anaplastic thyroid cancer
Prepared with OnCo (onco.cc/prep/anaplastic-thyroid-cancer/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
16 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example BRAF V600E, TP53 and TERT promoter mutations, PD-L1 expression, NTRK, RET and ALK fusions), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (diagnosis), which of the standard options do you recommend and why?
- 6.For my situation (braf v600e-mutant), which of the standard options do you recommend and why?
- 7.Am I a candidate for Dabrafenib, Trametinib, Pembrolizumab, and what side effects should I expect?
- 8.For my situation (braf wild-type, resectable), which of the standard options do you recommend and why?
- 9.Am I a candidate for Paclitaxel / nab-paclitaxel, Doxorubicin, and what side effects should I expect?
- 10.For my situation (unresectable braf wild-type), which of the standard options do you recommend and why?
- 11.Am I a candidate for Lenvatinib, and what side effects should I expect?
- 12.Are there clinical trials I could join, for example of Pembrolizumab, Lenvatinib?
- 13.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 14.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 15.I read that “Most patients still die within a year”. How does that affect my plan?
- 16.I read that “BRAF wild-type disease has no targeted option”. How does that affect my plan?
Tests and results to bring
Diagnosis: Core biopsy with rapid BRAF testing, airway assessment, staging CT and PET; multidisciplinary planning within days.
Biomarker results to ask for: BRAF V600E (urgent testing at diagnosis), TP53 and TERT promoter mutations, PD-L1 expression, NTRK, RET and ALK fusions (rare).
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- BRAF wild-type, resectable: Surgery followed by chemoradiation (paclitaxel- or doxorubicin-based). (Paclitaxel / nab-paclitaxel, Doxorubicin, IMRT / IGRT (modern external beam))
- Unresectable BRAF wild-type: Chemoradiation or immunotherapy in trials; lenvatinib in some countries; palliative radiotherapy and airway support. (Lenvatinib, Palliative radiotherapy, Early integrated palliative care)
- BRAF V600E-mutant: Dabrafenib plus trametinib, with pembrolizumab in many centres; neoadjuvant use to make tumours resectable, then surgery and radiotherapy. (Dabrafenib, Trametinib, Pembrolizumab)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.