Real-World Clinical Profile, Treatment Patterns And Patient-Reported Outcomes for Thyroid Cancer in Japan
Creators: name: Fukuda, Naoki
name: Tanizawa, Yoshinori
name: Nakamura, Kenichi
name: Okada, Yui
name: Segall, Grace
name: Kiiskinen, Urpo
name: Fasnacht, Nicolas
name: Sanderson, Isaac
name: Rider, Alex
name: Lewis, Katie
Publisher: name: Taylor & Francis
Year: 2024
Subjects: Medicine
Molecular Biology
Pharmacology
Biotechnology
Chemical Sciences not elsewhere classified
Cancer
Science Policy

description: <b>Aim:</b> To provide a real-world snapshot of the clinical profile, management, and patient-reported outcomes (PRO) for advanced medullary and papillary thyroid cancer prior to the availability of rearranged during transfection (RET) inhibitors in Japan. <b>Materials &amp; methods:</b> Physicians completed patient-record forms for eligible patients seen during routine clinical practice. Physicians were also surveyed about their routine practice and patients were asked to provide PRO data. <b>Results:</b><i>RET</i> testing patterns varied by hospital type; no therapeutic relevance was a commonly cited reason to not carry out testing. Multikinase inhibitors were the main systemic therapies prescribed, although timing to start multikinase inhibitors varied; adverse events were reported as challenges. PROs revealed high disease/treatment burden. <b>Conclusion:</b> More effective and less toxic systemic treatment targeting genomic alterations is needed to improve long-term outcomes of thyroid cancer. Thyroid cancer in Japan: which treatments are used in every-day clinical practice &amp; the impact of the disease &amp; treatments on people with this condition This survey, conducted in Japan in 2020, included doctors who treat thyroid cancer and their patients. It is called a real-world survey because it provides information such as the types of tests and treatments used for thyroid cancer management in everyday clinical practice. The survey focused on two types of thyroid cancer: papillary thyroid cancer (PTC), a common type, and medullary thyroid cancer (MTC), an uncommon type. About 10–20% of people with PTC and most people with MTC have alterations in a gene called <i>RET</i>, which caused the cancer. Laboratory tests can identify these gene alterations, fusions (joining the parts of two different genes) or mutations (changes to a gene’s DNA sequence) and results can help guide treatment decisions. The survey showed that testing for <i>RET</i> gene alterations was less than optimal and varied by the type of hospital/center. Common reasons provided by doctors for not testing for <i>RET</i> alterations were, “<i>no therapeutic relevance for patient management</i>” and “<i>specific targeted therapies not available</i>”. However, the survey was conducted before the availability in Japan of the treatment selpercatinib, which selectively targets/inhibits tumors with <i>RET</i> alterations. Most patients in the survey, including those with <i>RET</i> alterations, received treatment with a type of inhibitor called multikinase inhibitors, as per available guidelines. Doctors considered side effects due to inhibition of multiple targets by multikinase inhibitors to be among areas for improvement needed. People with PTC and MTC also reported substantial burdens (i.e., negative impact on their lives) from the disease/treatment. The researchers concluded that barriers to <i>RET</i> testing need to be overcome, and more effective and less toxic treatments targeting gene alterations are needed to improve long-term outcomes.