Presence Of Gene Mutation Helps Guide Thyroid Cancer Treatment

Hello friends, as you know I try to stay informed about research regarding Thyroid cancer. I take it personally. Here's some more data on the BRAF Gene research...looks great!

~Christy

Presence Of Gene Mutation Helps Guide Thyroid Cancer Treatment

Science Daily — A 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.

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.

The new research is reported in the September issue of the “Annals of Surgery.” 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.

Note: This story has been adapted from a news release issued by University of California - San Francisco.

Source:	University of California - San Francisco
Date:	September 6, 2007

New drug used to shrink Thyroid Cancer tumors [wow]

Hello friends - I am trying to keep us updated on the new info regarding Thyroid cancer. Generally there isn't much news to report as far as advances but this is a good one to pass along. Especially offers hope down the road in the event myself or someone else out there has a recurrence in the future. Hopefully *NOT* but it is comforting to know there will be even more options for us!

~ Christy


Axitinib (AG-01373) Shows Promise for Stabilising Thyroid Cancer, Shrinking Tumours: Presented at ASCO

By Cameron Johnston CHICAGO, IL -- June 4, 2007 -- The investigational drug axitinib (AG-013736) may have substantial activity in producing shrinkage of thyroid tumor, and possibly stabilising the disease, researchers reported here at the 43[^rd American Society of Clinical Oncology Annual Meeting (ASCO).

There has not been a new treatment for thyroid cancer in more than 30 years, and though more than 30,000 people are diagnosed with the disease every year in the US, the standard of care has remained either surgery or treatment with radioactive iodine. Still, a substantial percentage of people with the disease progress and fewer than 30% of those who fail standard therapy survive more than 5 years.

Axitinib is a potent inhibitor of the vascular endothelial growth factor receptors (VEGFr) 1, 2, and 3. It is delivered orally in pill form.

The small study presented on June 2nd at ASCO was conducted by investigators at the University of Chicago, Chicago, Illinois, United States, and headed by Ezra Cohen, MD, assistant professor of medicine, section of haematology/oncology.

The study involved 60 patients who had failed conventional therapy; 80% had had prior surgery and 70% had had prior radioactive iodine treatment. They represented several histological subtypes of the cancer but most were either papillary (48%) or medullary (25%), which are the 2 most common subtypes.

Patients were treated with 5 mg/day twice daily of oral axitinib.

The duration of response in patients ranged from 1 to 26 months, and overall, 18 patients responded to treatment (30%). Stable disease was seen in 25 patients (42%).

No response was seen in 28% (n = 17) patients.

Although this was a small and preliminary trial, Dr. Cohen said at least 37 patients (62%) were still alive and without evidence of progressive disease after more than 18 months of follow-up, and this was very promising for the future of the drug.

Axitinib also produced a relatively manageable adverse effects profile, with half of patients developing fatigue, of whom 3 (5%) were grade 3 or 4; and 28 (47%) who developed any degree of diarrhoea. Stomatitis/mucositis was seen in 26 (43%) patients. Five patients dropped out of the study due to adverse events.

According to Dr. Cohen, these findings represent a significant breakthrough in the treatment of refractory thyroid cancer, particularly since it has been so long since any new treatments were developed. There are no treatment options beyond surgery and/or radioactive iodine, he said.

It is clear that for certain patients, this may offer an important opportunity for treatment, Dr. Cohen said, but at this stage it may be useful to develop ways to identify patients who would respond best to this treatment, as well as to identify patients who are not likely to respond well to conventional therapies.


[Presentation title: A Phase I Study of Axitinib (AG-013736) in Patients With Advanced Thyroid Cancers. Abstract 6008]

So friends, it's Saturday morning and this is the first thing I heard on the news when I turned the TV on. Well there is nothing like the subject of toxic chemicals in our ground water supply poisoning us that lights a fire under my ass! This has long been a research topic of mine, since I am a thyroid disease and cancer survivor.

I just have to share this information as I think there is a large part of our population that has NO IDEA about perchlorate (rocket fuel) and how it's been affecting those of the US population with thyroid issues in ways which they are totally unaware.

I lived in Las Vegas for 15 years. Sometime around the year 2000 there was a report released regarding perchlorate in the water supply which was quickly hush-hushed as "minor amounts, blah blah blah....you are SAFE" (ahem, bullshit). I have thought for sometime now that my genetic predisposition for hypo/hyper-thyroidism + the Los Angeles area I grew up in + living in Vegas for 15 years [where above ground ATOMIC TESTING was done in the 40s & 50s] = what resulted in my thyroid cancer at 35 years old. Truth is, i will never know for sure since my doctors just say "we have no idea..."
-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=Rocket Fuel Chemical Found in Food, Water Supply
Studies Being Done to Determine Long-Term Effects of Small Amounts of Perchlorate on Human Health
April 28, 2007 — - Perchlorate, a chemical used in rocket fuel, is turning up in the nation's food -- in vegetables like lettuce and spinach -- and water supply.
You've never heard of it? Most Americans haven't, but millions have been exposed to it. This week Congress held hearings to determine just how dangerous it is to humans' health.
"A study from the Centers for Disease Control last year tested almost 3,000 people who are representative of the U.S. population. They found perchlorate in every single person," said Dr. Anila Jacob of the Environmental Working Group. so how did something used to launch inter-continental missiles and the space shuttle find its way into our homes?
At a hearing of the House Committee on Energy and Commerce this week, a government report was made public for the first time revealing that at sites in more than 25 states, perchlorate had leaked into the drinking water and soil. About 65 percent of that contamination was attributed to the Department of Defense and to NASA.
The Pentagon said it has invested "over $114 million in research related to perchlorate toxicity," and that they are "developing substitute chemicals." Doctors agree that large amounts of the chemical can lead to thyroid problems in adults and abnormal brain development in children, but it is still unknown how much damage smaller amounts can inflict.
"The developing fetus can have severe inhibition of brain development as a result of perchlorate intake by the mother through drinking water or through breast milk," Rep. Albert Wynn, D-Md. said.
Democrats on Capitol Hill are working on a bill that would require the EPA for the first time to set strict guidelines limiting the amount of perchlorate in the nation's drinking water.
For now, more research is being done to determine if the amounts present today can cause any serious damage to people's health.
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