Studies lead to innovation
Dana-Farber/Brigham and Women's Thyroid Cancer Center experts are leaders who regularly publish their discoveries about underlying disease mechanisms, surgical and radiation techniques, new therapies, and approaches to early detection.
We study how a tumor develops, what sustains its growth, and how to halt that growth. We then translate our understanding of the biology of thyroid cancers into new approaches to diagnosing and treating these diseases.
Our thyroid cancer patients have opportunities to participate in our research studies, including
clinical trials of new treatments.
Molecular and genetic studies
Our endocrinologists and cytopathologists are leaders in the use of diagnostic molecular markers, including gene expression classification and gene mutation panels, to increase accuracy in confirming benign or malignant disease. The team's ongoing research
into molecular analysis is also helping to better determine which patients require radioactive iodine or are at high risk for recurrence, and to modify treatment decisions appropriately.
Thyroid Cancer Center endocrinologist
Erik Alexander, MD, Chief of the Thyroid Section of the Division of Endocrinology, Diabetes and Hypertension at Brigham and Women's Hospital (BWH), is a member of a panel of the American Thyroid Association
that establishes guidelines for the management of thyroid nodules and thyroid cancer care.
Dr. Alexander was the lead author of a
multicenter study published in the New England Journal of Medicine (N Engl J Med 2012; 367:705-715). The study found that patients with cytologically
indeterminate nodules on fine needle aspiration (FNA) that are benign according to gene-expression classification should be considered for a more conservative approach to management.
Innovative tumor testing and targeted approaches for advanced thyroid cancers
The Center's medical oncologists have introduced innovative trials of targeted therapies for patients with advanced thyroid cancer:
Jochen Lorch, MD, MS, and
Nikhil Wagle, MD, led a study that outlined response and acquired resistance to the mTOR inhibitor everolimus in a 57-year-old patient with metastatic anaplastic thyroid cancer (N Engl J Med 2014;
371:1426-33). The patient had a near-complete response for 18 months before her disease progressed. As part of the study, whole-exome sequencing was performed on samples of the pre-treatment and resistant tumors, demonstrating the mechanisms of cancer
response and resistance. The team completed the study of everolimus, which is being presented for FDA approval for appropriate patients with thyroid cancer.
An investigator-initiated study of MLN0128, a new mTOR inhibitor, is now available for patients with anaplastic thyroid cancer and aggressive differentiated thyroid cancer. Tumor tissue sampling, performed as part of these studies, is linked with sequencing
data that allows researchers to correlate clinical response with genetic information.
A separate phase II study of the tyrosine kinase inhibitor (TKI) regorafenib is now open as a second- or third-line therapy for patients with metastatic medullary thyroid cancer.
Thyroid Cancer 360 Program
Our Thyroid Cancer 360 Program brings together world-class scientists and clinicians to bring personalized thyroid cancer treatment to the next level. Through innovative and unique lab techniques, many of which have been developed at Dana-Farber and the
Broad Institute of MIT and Harvard, we seek to gain as much information about your tumor as possible. Although primarily a research program, Thyroid Cancer 360 is designed to help identify the most appropriate targeted therapies for patients as their
cancer evolves, and to develop new therapeutic approaches in the treatment of advanced and aggressive thyroid cancers.
Optimizing surgical outcomes
Advanced Multimodality Image Guided Operating (AMIGO) Suite, our surgeons use real-time imaging and 3D models to:
- Identify small tumors
- Confirm that resection is complete
- Avoid injuring key nerves and vessels
DF/BWCC endocrine surgeon
Daniel Ruan, MD, was the first to utilize this technology during neck surgery, and the first to describe
MRI imaging of the recurrent laryngeal nerve during a thyroidectomy (N Engl J Med 2015; 373:96-98) to avoid injury to the nerve. Injury to this important nerve
during thyroid and parathyroid surgery can result in vocal cord paralysis, which can lead to problems with talking, swallowing, and breathing.