Targeted Therapy to Increase RAI Uptake in Patients With Metastatic DifferentiatedThyroid Cancer
Papillary thyroid cancer (PTC) is a common type of differentiated thyroid cancer (DTC) in children and represents the second most common cancer in adolescent females. Recently targeted drugs that block many of the genetic drivers of DTC have become available. While Investigators know that these drugs shrink DTC tumors in many cases, the impact on radioactive iodine (RAI) avidity has not been systematically studied.
• Patients with a histologic diagnosis of differentiated thyroid cancer
• Presence of an neurotrophic tyrosine kinase receptors (NTRK)-fusion, RET-fusion, anaplastic lymphoma kinase (ALK)-fusion, BRAF V600 mutation, BRAF-fusion or other targetable alteration identified in a Clinical Laboratory Improvement Amendments/College of American Pathologists (CLIA/CAP) laboratory
• Anatomically evaluable disease on chest Computed tomography (CT) meeting oneo f the following criteria (obtained within 180 days of enrollment):
‣ multiple (10 or more) noncalcified solid pulmonary nodules visible on CT and/or
⁃ enlarging, discrete pulmonary nodules visible on CT of any number consistent with metastatic disease
• Patients for whom systemic therapy with an oncogene-specific kinase inhibitor is planned from commercial supply or as part of a separate therapeutic clinical trial (that does not include data sharing with this protocol)/compassionate access protocol/single patient investigational new drug (IND). Such agents include, but are not limited to:
‣ Larotrectinib, entrectinib, selitrectinib, and repotrectinib for NTRK fusions
⁃ Selpercatinib and pralsetinib for RET fusions
⁃ Crizotinib, lorlatinib, repotrectinib, and alectinib for ALK fusions
⁃ Dabrafenib and/or trametinib for BRAF V600 mutations
⁃ Oncogene-specific kinase inhibitors other than those specifically delineated above must be approved by the overall study PI prior to enrollment
∙ 1\. Patients enrolled on other oncogene-specific targeted therapy trials who undergo whole body thyroid scan approximately 28 days after beginning targeted therapy and agree to data sharing as part of the consent process for that trial.