RAI only useful to 40% of Thyroid Cancer patients

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RAI only useful to 40% of Thyroid Cancer patients

by ToddlerFather on Sun May 19, 2019 01:12 AM

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Last year Astra Zeneca had already conceded that Selumetinib, one drug in their pipeline, failed to provide a response for those that took it besides doing radioactive iodine (RAI). 

The complete results took longer to be published, but they are now available at:

https://clinicaltrials.gov/ct2/show/results/NCT01843062?view

What I found interesting in the results is not that there is no meaningful difference between Selumetinib and Placebo, which they already said, but the percentage of those where RAI did provide a response: it is close to 40% in all cohorts. 

This is much less than what I thought happened, and makes Thyroid Cancer a not so easy to handle condition as it is usually said. The vulnerability to iodine is not as effective, although RAI selectiveness is still much better than other treatments. 



RE: RAI only useful to 40% of Thyroid Cancer patients

by nwerle on Thu May 23, 2019 07:57 PM

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your statment has no basis in fact

RE: RAI only useful to 40% of Thyroid Cancer patients

by ToddlerFather on Thu May 23, 2019 08:18 PM

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On May 23, 2019 7:57 PM nwerle wrote:

your statment has no basis in fact

The basis is available in the clinical trial results... have you read them ? You know that such a clinical trial follows a strict scientific protocol and this is one is performed by a leading researcher in the field, right ? 

RE: RAI only useful to 40% of Thyroid Cancer patients

by butterfly501 on Thu May 23, 2019 10:01 PM

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The clinical trial inclusion criteria was specifically for "Differentiated thyroid cancer Tumor >4 cm, or Gross extra-thyroid extension, or 1 lymph node >1 cm, or 5 or more lymph nodes of any size Previous thyroidectomy Must be able to receive radioactive iodine therapy Must be able to receive Thyroid Stimulating Hormone suppression"

This clinical trial does not apply to ALL cases of thyroid cancer.

RE: RAI only useful to 40% of Thyroid Cancer patients

by nwerle on Fri May 24, 2019 01:25 AM

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sorry - i was not talking about  placebo vs drug

re:  40% will put in next reply

RE: RAI only useful to 40% of Thyroid Cancer patients

by nwerle on Fri May 24, 2019 01:27 AM

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1 single oral dose of 100 mCi. thas is not standard

2 if you are talking RAI for existing thryroid,

still dont see your 40% result

3 RAI works in more than 40% of thryroid cases in General

RE: RAI only useful to 40% of Thyroid Cancer patients

by nwerle on Fri May 24, 2019 01:30 AM

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both papillary and follicular cancers have a more than 98% cure rate

RE: RAI only useful to 40% of Thyroid Cancer patients

by ToddlerFather on Fri May 24, 2019 02:49 AM

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On May 23, 2019 10:01 PM butterfly501 wrote:

The clinical trial inclusion criteria was specifically for "Differentiated thyroid cancer Tumor >4 cm, or Gross extra-thyroid extension, or 1 lymph node >1 cm, or 5 or more lymph nodes of any size Previous thyroidectomy Must be able to receive radioactive iodine therapy Must be able to receive Thyroid Stimulating Hormone suppression"

This clinical trial does not apply to ALL cases of thyroid cancer.

Most of the conditions are the same that guidelines prescribe Thyroidectomy. There are a few differences (like >2 cm x >4 cm) so this could make for a higher share of patients, like 50%. Yet it's still a less than stellar outcome. 

But if someone is willing to find tier divisions among patients in order to do a proper calculation, I am all ears and spreadsheet. 

RE: RAI only useful to 40% of Thyroid Cancer patients

by ToddlerFather on Fri May 24, 2019 02:52 AM

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On May 24, 2019 1:30 AM nwerle wrote:

both papillary and follicular cancers have a more than 98% cure rate

- Some of those could be left alone and die of anything other than thyroid cancer, due to slow growth. NIFTP is the poster child for this. 

- Some of those will have a cure due to thyroidtectomy. Most of the cases, but I will defer to a clinical trial that looks into this specific hypothesis. 

- And some of those might have a cure due to RAI. The point here is that RAI is not as a strong contributor to the overall cure rate as once thought. 

RE: RAI only useful to 40% of Thyroid Cancer patients

by butterfly501 on Fri May 24, 2019 03:36 AM

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On May 24, 2019 2:52 AM ToddlerFather wrote:

On May 24, 2019 1:30 AM nwerle wrote:

both papillary and follicular cancers have a more than 98% cure rate

- Some of those could be left alone and die of anything other than thyroid cancer, due to slow growth. NIFTP is the poster child for this. 

- Some of those will have a cure due to thyroidtectomy. Most of the cases, but I will defer to a clinical trial that looks into this specific hypothesis. 

- And some of those might have a cure due to RAI. The point here is that RAI is not as a strong contributor to the overall cure rate as once thought. 

You've decided to apply your opinion based on this one clinical trial that has nothing to do with testing the efficacy of I-131 ablation for all thyroid cancers. 

If I-131 were only useful in 40% of thyroid cancer patients there would be tons of research backing that up, in addition the use of I-131 would be even more deeply discussed and scrutinized in the professional guidelines by the American Thyroid Association.

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