Single-center retrospective study of neoadjuvant tyrosine kinase plus immune checkpoint inhibitors in anaplastic thyroid cancer

Most patients with anaplastic thyroid carcinoma (ATC) present with surgically unresectable disease. A retrospective study at Peking University Cancer Hospital and Institue (Beijing, China) evaluated the neoadjuvant combination of tyrosine kinase inhibitors and immunotherapy for patients with stages IVb and IVc ATC. The primary endpoints were rate of conversion to surgery, changes in tumor size, and surgical morbidity. Of the 27 patients treated with the combination, 11 (40.7%) achieved R0/R1 surgical resection. The median reduction in the largest tumor diameter was 54%. Mean surgical complexity scores decreased for baseline to surgery. Five patients achieved a complete response. Several major complications were observed, including one perioperative death. During a median follow-up of 36 months, median recurrence-free survival and median overall survival were not reached. The authors conclude that neoadjuvant combination therapy enhanced resectability and provided a potential curative option for patients with ATC; however, postoperative complications remain a significant concern.