Pralsetinib as neoadjuvant therapy for RET-Altered differentiated thyroid cancer: Two case reports

Nai-Si Huang; Jia-Ying Chen; Yan Meng; Qiu-Li Li; Qing-Hai Ji; Yu Wang

doi:10.1016/j.oraloncology.2024.107014

Pralsetinib as neoadjuvant therapy for RET-Altered differentiated thyroid cancer: Two case reports

Oral Oncol. 2024 Sep 21:159:107014. doi: 10.1016/j.oraloncology.2024.107014. Online ahead of print.

Authors

Nai-Si Huang¹, Jia-Ying Chen¹, Yan Meng², Qiu-Li Li³, Qing-Hai Ji¹, Yu Wang⁴

Affiliations

¹ Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College of Fudan University, Shanghai 200032, China.
² Department of Oncology, Hainan Cancer Hospital, Haikou, China.
³ State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China; Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China.
⁴ Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College of Fudan University, Shanghai 200032, China. Electronic address: neck130@hotmail.com.

PMID: 39306936
DOI: 10.1016/j.oraloncology.2024.107014

Abstract

Background: 5-10% of thyroid cancers are at locally advanced stage. Neoadjuvant targeted therapy will likely create surgical opportunities for these patients with unresectable or borderline resectable tumors. Pralsetinib, a RET inhibitor, has been approved for advanced or metastatic RET-altered thyroid cancer. However, there is no evidence on the efficacy of pralsetinib as neoadjuvant therapy in locally advanced RET-altered thyroid cancer.

Case report: Two patients with locally advanced pappilary thyroid carcinoma (PTC) were treated with pralsetinib (400 mg daily) to reduce tumor size and increase the chance of R0 resection. Both PTCs, characterized by RET-fusion, underwent successful R0 resection without major surgical complications after 4-months neoadjuvant pralsetinib.

Conclusion: There is a potential for pralsetinib as a neoadjuvant treatment in PTC with RET-fusion.

Keywords: Differentiated thyroid carcinoma; Neoadjuvant therapy; Papillary thyroid carcinoma; Pralsetinib; RET-fusion.

Publication types

Letter