Table 3.
Summary of redifferentiation therapy trials in DTC.
| TKI | Duration of TKI prior to RAI | Evaluable patients (n) | Restoration of uptake (n) | Patients treated with RAI | Efficacy results | Reference |
|---|---|---|---|---|---|---|
| Selumetinib | 4 weeks | 20 | 12/20 | 5/5 NRAS MUT 1/9 BRAF MUT 1/3 RET fusion 1/3 WT |
At 6 months: 5/8 PR 3/8 SD |
Ho et al. (112) |
| Dabrafenib | 6 weeks | 10, all with BRAF V600E mutations | 6/10 | 6 | At 3 months: 2/6 PR 4/6 SD |
Rothenberg et al. (113) |
| Vemurafenib | 4 weeks | 10, all with BRAF V600E mutations | 6/10 | 4 | At 3 months: 2/4 PR 2/4 SD |
Dunn et al. (114) |
| Trametinib if BRAF-WT, dabrafenib + trametinib if BRAF-mutated | 21 ± 3 days | 20 | 7 | 5/14 BRAF WT 2/6 BRAF MUT |
At 1 year: 1/7 PR 5/7 SD 1/7 PD |
Weber et al. (115) |
| Dabrafenib + trametinib in BRAF-mutated RR-DTC | 42 days | 21 | 11/17 at 4 weeks 20/21 on PTWBS |
21 | At 6 months: 8/21 PR 11/21 SD 2/21 PD |
Leboulleux et al. (116) |
| Trametinib | 4 weeks | 25 RAS MUT, 9 RAS WT | 19 | 14/25 RAS MUT 3/4 BRAF MUT 1/4 RET altered |
At 6 months: PR 9/18 SD 6/18 PD 3/18 |
Burman et al. (117) |
| BRAFi+/- MEKi if BRAF-mutated, MEKi if RAS-mutated, trametinib in WT patient |
0.9 – 76.4 months | 13 | 8/13 | 3/3 RAS MUT 5/9 BRAF MUT 1/1 WT* |
3/9 PR 6/9 SD |
Jaber el al (118). |
| Trametinib if RAS-mutated, dafrafenib/trametinib or vemurafenib/cobimetinib if BRAF-mutated | 4 weeks | 6 | 4/6 | 1/3 RAS MUT 3/3 BRAF MUT |
3/4 PR 1/4 SD |
Iravani et al. (119) |
*Patient treated empirically with 131I despite no restoration of uptake on diagnostic whole-body scan.
WT, wild type; BRAFi, BRAF inhibitor; MEKi, MEK inhibitor; PTWBS, post-therapeutic whole body scan; MUT, mutant.