Abstract 1750P
Background
The management of radioiodine refractory -RAIR) thyroid cancers (TC), metastatic medullary thyroid cancer (MTC), and anaplastic thyroid cancer (ATC) has recently changed with the arrival of new treatments that target specific molecular abnormalities. Differences in the ability to offer molecular somatic screening and targeted treatments can lead to disparities in cancer care among different European countries.
Methods
From Nov 18th 2020 to Jan 18th 2021, an online survey invitation was sent to EURACAN G6 Group, EORTC Endocrine Group and ETA members. It comprised 19 questions regarding country, medical practice modalities, molecular genotyping capacities, reimbursement and treatment access modalities.
Results
A total of 86 practitioners from 18 European Union countries (n=83), Switzerland (n=2) and Turkey (n=1) responded. Most were endocrinologists (47.7%) and worked in academic centres (57.1%). Forty-seven of them (44.2%) declared being routinely involved in managing aggressive TC including 38/47 (80.9%) regularly prescribing somatic molecular genotyping. The preferred methods were tumor DNA-based techniques for gene mutations (89.8%) and gene fusions (64.4%), which were mainly funded by national healthcare systems (73.7%). Among those not prescribing molecular analyses, main reasons were lack of reimbursement (46.7%), lack of established workflow (46.7%) and lack of access to targeted therapies (40%). The most frequently searched molecular alterations were BRAF mutations, RET and NTRK fusions in RAIR-TC, RET mutations in MTC, and BRAF mutations and NTRK fusions in ATC. Access to selective inhibitors is mainly driven by clinical trials, with routine-access to therapies being available in only 40% of the institutions.
Conclusions
This survey, examining molecular genotyping in aggressive TC, shows that most of the respondents regularly use gene sequencing in these rare cancers, even if selective targeted therapies are not easily and equally available throughout Europe. Clinical trials are important to facilitate access to innovative treatments in rare cancers. Collaboration with underrepresented European countries could be developed by scientific societies.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
C. de la Fouchardiere: Financial Interests, Personal, Advisory Board, null: Merck; Financial Interests, Personal, Advisory Board, null: Roche; Financial Interests, Personal, Advisory Board, null: Lilly; Financial Interests, Personal, Advisory Board, null: Bayer; Financial Interests, Personal, Advisory Board, null: Amgen; Financial Interests, Personal, Advisory Board, null: MSD; Financial Interests, Personal, Advisory Board, null: Servier; Financial Interests, Personal, Invited Speaker, null: Ipsen; Financial Interests, Personal, Invited Speaker, null: Eisai; Financial Interests, Personal, Advisory Board, null: Pierre Fabre Oncologie; Financial Interests, Institutional, Invited Speaker, null: Pierre Fabre Oncologie; Financial Interests, Institutional, Invited Speaker, null: Servier. G. Costante: Financial Interests, Personal, Expert Testimony: Lilly. E. Grande: Financial Interests, Personal, Invited Speaker: Adacap; Financial Interests, Personal, Advisory Board: Astellas; Financial Interests, Personal, Invited Speaker: Astra Zeneca; Financial Interests, Personal, Advisory Board: Bayer; Financial Interests, Personal, Invited Speaker: BMS; Financial Interests, Institutional, Advisory Board: Caris Life Sciences; Financial Interests, Personal, Invited Speaker: Eisai; Financial Interests, Personal, Invited Speaker: Eusa Pharma; Financial Interests, Personal, Invited Speaker: IPSEN; Financial Interests, Personal, Invited Speaker: Janssen; Financial Interests, Personal, Invited Speaker: Lilly; Financial Interests, Personal, Invited Speaker: Merck GA; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: ONCODNA; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Advisory Board: Sanofi-Genzyme; Financial Interests, Institutional, Research Grant: Astellas; Financial Interests, Institutional, Research Grant: Astra Zeneca; Non-Financial Interests, Institutional, Other: Ipsen; Non-Financial Interests, Institutional, Invited Speaker: Lexicon; Non-Financial Interests, Institutional, Invited Speaker: MTEM/Threshold; Non-Financial Interests, Institutional, Research Grant: Nanostrinf Technologyes; Non-Financial Interests, Institutional, Research Grant: Pfizer; Non-Financial Interests, Institutional, Research Grant: Roche; Other, Personal, Member of the Board of Directors: ENETS. J. Blay: Financial Interests, Personal and Institutional, Research Grant: Roche; Financial Interests, Personal and Institutional, Research Grant: Bayer; Financial Interests, Personal and Institutional, Research Grant: Ignyta; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: Bayer; Financial Interests, Personal, Invited Speaker: Ignyta. L.D. Locati: Financial Interests, Institutional, Research Grant: Eisai; Financial Interests, Personal, Invited Speaker: Eisai; 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; Financial Interests, Personal, Invited Speaker: Biogene. All other authors have declared no conflicts of interest.