1754P - Current picture of Anaplastic Thyroid Cancer patients' care and meetable needs: A survey of 94 institutions from the EORTC Endocrine and Head and Neck Cancer Groups

Background

Anaplastic thyroid carcinoma (ATC) is a rare cancer accounting for 40% of thyroid cancer-specific deaths. Median overall survival is 6 months. In the last 5 years, improved insights into molecular pathways led to the approval of BRAF/MEK inhibitors (B/Mi) in BRAF^V600E-mutant ATC in the U.S.A. Nevertheless, many clinicians face challenges in prescribing new treatments, included immunotherapy (IO). The extent of this phenomenon is unknown in Europe, where no new treatment for ATC has been approved yet. We launched a survey to catch a picture of the current situation.

Methods

From March 12^th to 19^th 2021, an online survey invitation was sent to 239 Institutions within the EORTC Endocrine and Head&Neck Cancer Groups. It posed 7 questions: (1) number of ATC pts evaluated per year (y) (< 5; 5-10; 10-15; >15). (2) Feasibility of BRAF status assessment and (3) technology used (PCR; IHC; NGS). (4) Accessibility to B/Mi and (5) IO. (6) Availability of clinical trials; (7) Interest in conducting clinical trials for ATC pts. Answers were analyzed at the Istituto Nazionale dei Tumori in Milan, Italy.

Results

A total of 94 Institutions from 20 Countries answered the survey. 30 Centres evaluate ≥ 5 ATC pts/y (23.5% 5-10 pts/y, 4.2% 10-15, 3.1% >15) with a global incidence >200 pts/y. 80.8% test BRAF mutation (58.5% always, 22.3% frequently); the most used method is NGS (43.6%) followed by IHC (29.7%) and PCR (22.3%). Most clinicians experience limitations in prescription: 12.7% and 26.5% do not prescribe B/Mi and IO, respectively. 50% offer B/Mi and 43.6% IO only under certain conditions (e.g. health insurance coverage, clinical trials, compassionate use, off-label). 13.8% have clinical trials ongoing and 8.5% upcoming. 91.5% of the responders claimed for clinical trials dedicated to ATC pts.

Conclusions

Despite the guidelines’ recommendations (ESMO, ATA, NCCN), there are evident interinstitutional disparities in novel treatments access. Albeit ATC is a rare cancer, clinical trials seem feasible within an appropriate network of referral sites. Access to cutting-edge therapies is an urgent issue in this setting, therefore it is time for a call to action for multicenter prospective trials dedicated to ATC pts.

Clinical trial identification

Editorial acknowledgement

We aknowledge all the members of the EORTC Endocrine and Head&Neck Cancer Groups who took part in this survey.

Legal entity responsible for the study

EORTC Endocrine Tumours Group.

Funding

Has not received any funding.

Disclosure

L.D. Locati: Financial Interests, Institutional, Research Grant: EISAI; Financial Interests, Personal and Institutional, Invited Speaker: EISAI; Financial Interests, Personal, Invited Speaker: IPSEN; Financial Interests, Personal, Invited Speaker: BMS; Financial Interests, Personal, Invited Speaker: Eli Lilly; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Personal, Invited Speaker: Merck Serono; Financial Interests, Personal, Invited Speaker: McCann Healthcare. All other authors have declared no conflicts of interest.