Clinical and molecular features and survival in thyroid cancer with brain metastases.

• DOI: 10.1200/jco.2024.42.16_suppl.2023
• Publication Date: 2024-06-04T19:02:17Z
• Authors: Carly C. Barron; Thais Baccili Cur...; Yangqing Deng; Erick Figueiredo ...; Gordon Taylor Moffat; Richard Thomas O'...; Aruz Mesci; Jelena Lukovic; Richard Tsang; Ozgur Mete; Monika K. Krzyzan...; Lucy Xiaolu Ma
• Keywords: Brain cancer

2023 Background: Brain metastases (BM) in advanced thyroid cancer are rare; however, they may be underreported as staging brain imaging is not routine. Prognostic features and molecular alterations for this group poorly described. We characterized the clinical of with BM evaluated differences survival. Methods: In single-center retrospective analysis, patients metastatic radioactive iodine refractory well-differentiated, poorly-differentiated, or medullary carcinoma seen at Princess Margaret Cancer Center from 2007-2022 were included. Electronic medical records reviewed to collect clinicopathologic treatment data. All had tumor next-generation sequencing (NGS) by a targeted gene panel. Overall survival (OS) initial oncology consultation was analyzed using Kaplan-Meier method univariate multivariate Cox proportional hazards models. Results: Of 248 cancer, 41(17%) diagnosed BM. The median interval diagnosis development 6.49 years (y) (IQR 3.51- 14.35 y). age time 63.6 y 23 (56%) male. Most (76%) asymptomatic 80% an ECOG 0-1. Among well-differentiated histology, 27 (18%) developed BM, while 7 (12%) poorly-differentiated (19%) most common included BRAFV600E (n=19), TERT (n=11), RAS (n=9), RET (n=8), FANCA (n=3). Patients treated surgery (n=5), stereotactic radiation (n=21), whole therapy (n=12), combination both (n=2). OS similar compared those without (6.05 vs 6.45 There no histology between that who did not. 3.23 y. ≥4 lesions worse (0.52 5.09 y, p=0.01). based on symptoms, among Conclusions: This one largest reported cohorts first complete NGS. prevalence our cohort higher than previously described, often incidentally. Screening detect rates, offering prognostic insights. While number predictive survival, predict larger studies needed.