The specialist highlights the scope of the results in diagnosis and treatment.
Dr. María Cabanillas, a cancer endocrinologist at the University of Texas Anderson Cancer Center. Photo: Journal of Medicine and Public Health.
In an exclusive interview with the Journal of Medicine and Public HealthDr. Maria Cabanillasoncological endocrinologist at the Anderson Cancer Center from University of Texasrevealed the impact of the research that has been carried out on the cancer anaplastic.
In principle, the endocrinologist oncologist reported that this type of cancer is the result of a thyroid cancer that has been around for a long time, “the more days go by, the tumors begin to acquire new mutations and by accumulating more mutations, they become more aggressive , giving as final result, cancer anaplastic”.
The specialist indicated that between the last 5 and 10 years more people with this type of cancer have been detected, due to the fact that detection tests have also increased because answers are sought as to why the tumor acts so aggressively.
This type of cancer mainly affects patients adults but, as indicated by Cabanillas, they have also found patients between 40 and 45 years of age with these tumors.
Start of investigations
One of the events that marked the Dr. Maria Cabanillaswas meeting and patient who traveled from Italia looking for help because your cancer anaplastic that had already metastasized, “in reality we had nothing to offer him for treatment at that time -2012, we could only treat him with chemotherapy that was already authorized for head and neck”.
He explained that at that time the team from the Anderson Cancer Center at the University of Texas began looking for ways to meet and care for more patients with this condition with the aim of obtaining information that would serve as a starting point to provide better results in the diagnosis and treatment.
He recalled that in 2013 he asked his colleagues to send the patients con anaplastic cancer to his office, “but I realized that I couldn’t do it alone, so in 2014 a multidisciplinary group came together to see the patients with an attention between 5 and 7 days once they contacted us”.
“Offering them a speedy appointment helped increase and improve care. Understand that anaplastic is not just one, but that there are different types of cancer that affect the thyroid gland and this becomes this type of cancer, ”she indicated.
One of the aspects we found is that they are not all treated the same, they are different types of cancer, “because we are beginning to see the mutations of the cancers in each one of them. That is, we saw a patient con anaplastic cancer with a papillary next to it. This is how we began to understand that it is not a type of cancer, and that is why not everyone can be treated the patients Same”.
Research input
The specialist explained that the phase two clinical trial they carried out with patients around the world measured the effects of the only two drugs approved for cancer anaplastic, “but after 14 months half of the patients They stopped responding to treatment and died.
Noting this setback, the researchers opted to include immunotherapy for both drugs, and the results were favorable for the patients.
“What we did was add immunotherapy with the other drugs, a Braf inhibitor, a Med inhibitor, and the third one which is immunotherapy, and with this combination we found that at 24 months 72 percent of the patients they are alive. So we are looking at how to change the treatment from just giving two drugs to three drugs,” he explained.
Another of the studies being carried out, according to Dr. Cabanillas, has to do with the tumor itself, “as we saw that they cannot be removed, because when a patient anaplastic is diagnosed, the tumor is very large, and what we did was treat the patient before surgery and continue treatment after surgery or give them radiation. So we are studying whether this surgery benefits the patients”.
He added that there comes a point where, due to the size of the tumor, the patient cannot breathe, and there comes a point in treatment where the progression of the drugs stops and the tumor accumulates new mutations.
“The drug no longer works on new mutations, and then the patient does not have many options, so before that happens we want to remove the tumor from the patient,” he explained.
Regarding goals and challenges, Dr. Cabanillas indicated that only 40 percent of the patients con anaplastic cancer they have a Braf mutation and they are the ones who benefit from this treatment, but there are also patients who have mutations that are more complicated to treat.
“We give them combined treatment and not all of them respond, so we are trying to see what the difference is between the patients that respond well to immunotherapy and others do not, through the tissue. I hope to publish this research this year, but we still have a lot of work ahead of us with the patients that do not have a mutation in Braf”, he explained.
People are realizing that understanding this cancer at the molecular level is very important, that message has already reached Puerto Rico and Latin America. “In the latter, the biggest challenge is access to treatments, but little by little with the publication of trials and professional guidelines, then I think it has improved a lot, but it is still a problem for the poorest countries.”
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