Targeted treatment offers new hope to advanced thyroid cancer patients
As both a physician and a cancer patient, Elizabeth Panke, MD, PhD, understands the power of personalized treatment – that which targets the genomics and biology of an individual's specific cancer. She credits the therapy approach for saving her life nearly 20 years ago when traditional chemotherapy was ineffective. Now, Panke is partnering with Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) on a new initiative she hopes will help others achieve long-term survivorship.
The Thyroid Cancer 360 Program, led by specialists in the Thyroid Cancer Center at DF/BWCC, provides targeted treatments to improve outcomes for patients with advanced and aggressive thyroid cancers. Panke and her husband, Thomas, both Ohio-based pathologists, have long been committed to seeking out and supporting efforts in personalized cancer medicine (also known as precision cancer medicine) nationwide. When they read about Jochen Lorch, MD, MS, director of the Thyroid Cancer Center, and his team, the Pankes were impressed by the steps the center was taking to wipe out this disease.
"A landmark 2014 study, led by Dr. Lorch, showed a patient with a typically deadly anaplastic thyroid cancer had a dramatic response to treatment personalized to their tumor," says Panke, a survivor of thyroid, ovarian, and uterine cancer. "Dr. Lorch uncovered mutations in the tumor that enabled this response, a prime example of personalized cancer treatment at its best. Through this work, he expanded our understanding of diagnostic and treatment strategies for one of the most aggressive and difficult to treat thyroid cancers."
There were personal as well as professional reasons for Panke to reach out to Lorch. Although she was free of ovarian and endometrial cancer as of 2014, thanks to personalized treatment decades before, Panke's thyroid cancer was not responding to therapy. She had a total thyroidectomy and radioactive iodine treatment, but the tumors had spread to her lungs – an aggressive response that occurs in about 10 percent of patients with differentiated thyroid carcinomas.
Personalized Cancer Treatment Brings Hope
Panke saw hope in DF/BWCC and the Thyroid Cancer Center for such patients – including herself.
"While most thyroid cancer patients are cured with standard therapy, these patients develop refractory disease that is incurable and has a poor prognosis," says Lorch. "Our personalized cancer treatment program is designed to help identify the most appropriate targeted therapies for these patients as their cancer evolves, and to develop new therapeutic approaches in the treatment of advanced and aggressive thyroid cancers."
In addition to sending Lorch an archive of her tumor samples to study for mutations and possible links between her ovarian and thyroid cancers, Panke and her husband established the Panke Thyroid Cancer Research Fund at DF/BWCC in 2015. The fund supports the Thyroid Cancer 360 Program, which studies individual thyroid tumor genomic and biological profiles to further develop diagnostic and treatment strategies. Resources at Dana-Farber, Brigham and Women's Hospital, and Harvard Medical School are all being used to grow the program's database.
"The key is looking at tumor material as many times as necessary throughout treatment to get as much information from the tumor as possible," says Lorch. "We consider DNA, RNA, and live cell testing during the patient's course of therapy to see if the tumor responds to immunotherapy (which uses the patient's own immune system to fight cancer) or a panel of drugs that we can test in vitro."
Studying Panke's tumor samples, Lorch's team found no link between her ovarian and thyroid cancers – but they did identify a new mutation in a gene which may be a useful target in thyroid cancer patients.
The Thyroid Cancer Center is also enrolling patients for a clinical trial – the first immunotherapy trial specifically designed for patients with thyroid cancer. The study is using a drug combination cultivated in part from the center's research efforts. Lorch, principal investigator for the study, is hoping it will lead to tumor cell death and tumor shrinkage.