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These findings suggest that novel therapies employing HNHA alone, or in integration with usual chemotherapeutic agents, could improve outcomes in aggressive thyroid cancer.
On the basis of our in vitro results, we predicted that the three drug combination would result in tumor apoptosis in an 8505c thyroid orthotopic model of aggressive thyroid cancer with wide spread lung metastases.
Further studies in genetically engineered models of aggressive thyroid cancer in mice, which harbor additional mutations such as p53 and BRAF, will undoubtedly shed light on the true efficacy of a combinatorial strategy.
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We previously demonstrated that nuclear and cytoplasmic accumulation of the intracellular domain (Ep-ICD) of epithelial cell adhesion molecule (EpCAM) accompanied by a reciprocal reduction of its extracellular domain (EpEx), occurs in aggressive thyroid cancers.
Notably, our earlier report in thyroid cancers demonstrated a strong association between nuclear accumulation of Ep-ICD and a reduced membranous EpEx localization as well as shortened overall survival, suggesting the potential application of the relative subcellular expression of Ep-ICD versus EpEx as prognostic markers for aggressive thyroid cancers.
Aggressive thyroid cancers remain resistant to traditional chemotherapeutic agents.
The anaplastic (ATC) and aggressive thyroid cancers showed loss of EpEx and increased nuclear and cytoplasmic accumulation of Ep-ICD.
Also, FOXA1 is over-expressed in aggressive thyroid cancers (ATC) and involved in cell cycle progression via down-regulation of p27Kip1 in an ATC cell line [ 30].
Inhibition of Akt might be of great benefit to patients with aggressive thyroid cancers, and support for the concept of targeting Akt comes from many observations.
FDG PET is also useful in the patient with a neck mass but unknown primary, in patients with aggressive (dedifferentiated) thyroid cancer, and in patients with differentiated cancer where histologic transformation to dedifferentiation is suspected.
17 Based on these encouraging data, a phase II trial was performed using axitinib given at a dose of 5 mg twice daily in patients with all types of aggressive incurable thyroid cancer.
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