Clinical trial for genetic cancer test to offer safe thyroid-preserving surgery

February 8, 2017
Credit: University of Pittsburgh Schools of the Health Sciences

University of Pittsburgh School of Medicine scientists and doctors are embarking on the first-ever clinical trial to determine if a genetic test they pioneered could successfully spare patients with nonaggressive thyroid cancer from complete removal of their thyroid, a butterfly-shaped gland in the neck that is important to hormone regulation and development. Such thyroid-preserving surgery minimizes surgical complications, and many patients also may avoid taking medication every day to keep thyroid hormone levels in check.

The two-year trial, which is entirely philanthropically funded by individual donors affected by , will investigate whether the UPMC-developed molecular genetic test ThyroSeq can correctly differentiate between thyroid cancers most likely to spread and need complete removal of the , and those likely to be far less invasive, warranting a thyroid-preserving surgical approach.

"We're looking at potentially saving from unnecessary ," said Linwah Yip, M.D., principal investigator of the trial. "Today we use the most recent developments in cancer genetics to guide treatment for many types of cancers such as breast and colon; we are hoping to safely apply the same approach to thyroid cancer. It's really exciting to be on the verge of tailoring the extent of precisely to the aggressiveness of the cancer," added Yip, an associate professor of surgery in Pitt's Clinical and Translational Science Institute.

About 56,870 cases of thyroid cancer are diagnosed in the U.S. every year, and about 2,010 people die of the disease, according to the American Cancer Society.

Under current guidelines of the American Thyroid Association, when patients are diagnosed preoperatively with thyroid cancer, which means a small sample of their thyroid has cancerous cells, they can start by having just half of their thyroid removed. Often, this allows the remaining part of the thyroid to continue functioning naturally without long-term medication. However, a second thyroid operation can then be required if the removed cancer is an aggressive type. Alternatively, under the current guidelines, patients can skip the initial removal of half the thyroid and proceed straight to full removal, but they will definitely need medication for the rest of their lives.

"When we get a biopsy result that is positive for cancer before surgery, there are not a lot of tools that we can use to decide with patients which surgery is best," said Sally E. Carty, M.D., professor of surgery and co-director of the UPMC/University of Pittsburgh Cancer Institute Multidisciplinary Thyroid Center (MTC). "It becomes an educated guess that also is informed by the patient's preference to either perform a partial removal of the gland and accept a potential repeat surgery if the cancer is found to be aggressive, or to remove the entire thyroid in the initial surgery."

ThyroSeq is a genetic test developed by a scientific team lead by Yuri Nikiforov, M.D., Ph.D., director of UPMC's Division of Molecular and Genomic Pathology and co-director of the MTC. UPMC's latest version allows pathologists to simultaneously test 14 genes for 42 markers of thyroid cancer using just a few cells collected during the initial biopsy.

The test has performed well at differentiating between cancerous and noncancerous thyroid nodules, already sparing patients from unnecessary surgeries.

Over the next two years, Yip and her colleagues plan to enroll about 100 patients who are newly diagnosed with thyroid cancer. Each participant's biopsy sample will be tested with ThyroSeq to determine whether the cancer has an aggressive or nonaggressive genetic signature. The patients and their doctors can then use that knowledge to decide whether to remove half or the entire thyroid.

In addition, the clinical trial also will evaluate the quality-of-life parameters associated with complete removal of the thyroid gland.

"I'm particularly passionate about this part of the trial because it will help us to know whether all of our efforts to preserve the are worth it," said Yip. "We all want to make sure that patients' quality of life is considered to truly provide personalized surgical and cancer treatment recommendations."

This trial can be found on ClinicalTrials.gov with the identifier NCT02947035.

Explore further: CVD, osteoporosis risk up for young thyroid cancer survivors

Related Stories

CVD, osteoporosis risk up for young thyroid cancer survivors

January 26, 2017
(HealthDay)—Younger survivors of thyroid cancer are at increased risk for certain types of health problems later in life, according to a study presented at the American Society of Clinical Oncology's Cancer Survivorship ...

Next-gen sequencing test identifies cancerous thyroid nodules with high degree of accuracy

September 15, 2015
A next-generation sequencing test is successfully predicting which thyroid nodules are cancerous and require surgical removal, reducing the need for multiple invasive diagnostic procedures, according to researchers at the ...

Scientists lead consensus guidelines for thyroid cancer molecular tests

July 6, 2015
University of Pittsburgh Cancer Institute (UPCI) scientists recently led a panel of experts in revising national guidelines for thyroid cancer testing to reflect newly available tests that better incorporate personalized ...

Test increases odds of correct surgery for thyroid cancer patients

July 25, 2014
The routine use of a molecular testing panel developed at UPMC greatly increases the likelihood of performing the correct initial surgery for patients with thyroid nodules and cancer, report researchers from the University ...

Next generation sequencing test improves detection of thyroid cancer, reduces unnecessary surgeries

October 1, 2013
A new test for genetic markers that can identify which lumps in the thyroid gland are cancerous and which are harmless – potentially preventing unneeded operations – will make its debut Oct. 1 for patients seeking care ...

Thyroid health important to all, says expert

September 15, 2016
Thyroid problems are five to eight times more likely to impact women than men. However, Baylor College of Medicine's Dr. Ruchi Gaba cautions that any person, regardless of gender or age, can be affected by thyroid issues.

Recommended for you

Researchers discover specific tumor environment that triggers cells to metastasize

November 21, 2017
A team of bioengineers and bioinformaticians at the University of California San Diego have discovered how the environment surrounding a tumor can trigger metastatic behavior in cancer cells. Specifically, when tumor cells ...

New study points the way to therapy for rare cancer that targets the young

November 21, 2017
After years of rigorous research, a team of scientists has identified the genetic engine that drives a rare form of liver cancer. The findings offer prime targets for drugs to treat the usually lethal disease, fibrolamellar ...

Clinical trial suggests new cell therapy for relapsed leukemia patients

November 20, 2017
A significant proportion of children and young adults with treatment-resistant B-cell leukemia who participated in a small study achieved remission with the help of a new form of gene therapy, according to researchers at ...

Cell-weighing method could help doctors choose cancer drugs

November 20, 2017
Doctors have many drugs available to treat multiple myeloma, a type of blood cancer. However, there is no way to predict, by genetic markers or other means, how a patient will respond to a particular drug. This can lead to ...

Researchers discover a new target for 'triple-negative' breast cancer

November 20, 2017
So-called "triple-negative" breast cancer is a particularly aggressive and difficult-to-treat form. It accounts for only about 10 percent of breast cancer cases, but is responsible for about 25 percent of breast cancer fatalities.

Study reveals new mechanism used by cancer cells to disarm attacking immune cells

November 20, 2017
A new study by researchers at The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute (OSUCCC - James) identifies a substance released by pancreatic cancer cells that protects ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.