{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T03:44:47Z","timestamp":1772855087964,"version":"3.50.1"},"reference-count":24,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A 65-year-old patient presented with recurrent, locally advanced poorly differentiated thyroid cancer despite 2 neck surgeries, and with newly diagnosed brain and skull base metastases. He was treated with palliative stereotactic radiosurgery to the brain and skull base lesions. Thereafter, as no targetable genetic alteration was identified and antiangiogenic multikinase inhibitors were deemed at high risk of hemorrhagic complications, off-label systemic therapies were considered. The mechanistic target of rapamycin (mTOR) inhibitor everolimus could not be obtained due to lack of insurance coverage, so the patient was treated with single-agent pembrolizumab. He showed an initial remarkable response, but unfortunately had disease progression in the neck and upper mediastinum after 1 year of therapy. At that time, he was treated with external beam radiotherapy, with concomitant pembrolizumab. He was then found to have an CTSB::ALK fusion, which has previously been described in 2 cases of thyroid cancer. However, as he showed a positive response to radiation with pembrolizumab, he continued single-agent immune checkpoint inhibition and had a persistent marked response almost a year after completing radiation. The patient was then followed at an outside institution and was transitioned to hospice at time of progression per his preference. He died 4 years after his initial diagnosis.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf015","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T10:39:49Z","timestamp":1737715189000},"source":"Crossref","is-referenced-by-count":1,"title":["Recurrent Poorly Differentiated Thyroid Cancer Successfully Treated With Radiation and Immunotherapy"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1528-9885","authenticated-orcid":false,"given":"Sarah","family":"Hamidi","sequence":"first","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer , Houston, TX 77030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2932-5584","authenticated-orcid":false,"given":"Matthew S","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas MD Anderson Cancer , Houston, TX 77030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5977-6004","authenticated-orcid":false,"given":"Jack","family":"Phan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas MD Anderson Cancer , Houston, TX 77030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7918-9739","authenticated-orcid":false,"given":"Mark E","family":"Zafereo","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer , Houston, TX 77030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4418-3705","authenticated-orcid":false,"given":"Maria K","family":"Gule-Monroe","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, The University of Texas MD Anderson Cancer , Houston, TX 77030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3776-208X","authenticated-orcid":false,"given":"Ramona","family":"Dadu","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer , Houston, TX 77030 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"issue":"2","key":"2025020513061038100_luaf015-B1","doi-asserted-by":"crossref","first-page":"e220293","DOI":"10.1530\/ERC-22-0293","article-title":"The 2022 WHO classification of thyroid tumors: novel concepts in nomenclature and grading","volume":"30","author":"Christofer Juhlin","year":"2023","journal-title":"Endocr Relat Cancer"},{"issue":"3","key":"2025020513061038100_luaf015-B2","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1089\/thy.2018.0509","article-title":"Poorly differentiated carcinoma of the thyroid gland: current status and future prospects","volume":"29","author":"Ibrahimpasic","year":"2019","journal-title":"Thyroid"},{"issue":"11","key":"2025020513061038100_luaf015-B3","doi-asserted-by":"crossref","first-page":"2306","DOI":"10.1056\/NEJMra1501993","article-title":"Biologic and clinical perspectives on thyroid cancer","volume":"375","author":"Fagin","year":"2016","journal-title":"N Engl J Med"},{"issue":"4","key":"2025020513061038100_luaf015-B4","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1002\/jso.23656","article-title":"External beam radiotherapy with or without concurrent chemotherapy in advanced or recurrent non-anaplastic non-medullary thyroid cancer","volume":"110","author":"Romesser","year":"2014","journal-title":"J Surg Oncol"},{"issue":"16_suppl","key":"2025020513061038100_luaf015-B5","doi-asserted-by":"crossref","first-page":"6106","DOI":"10.1200\/JCO.2024.42.16_suppl.6106","article-title":"Cobimetinib plus atezolizumab for RAS and NF1\/2-mutated poorly differentiated thyroid carcinoma","volume":"42","author":"Hamidi","year":"2024","journal-title":"J Clin Oncol"},{"issue":"suppl_7","key":"2025020513061038100_luaf015-B6","first-page":"S750","article-title":"1646MO\u2014phase II ATLEP trial: final results for lenvatinib\/pembrolizumab in metastasized anaplastic and poorly differentiated thyroid carcinoma","volume":"33","author":"Dierks","year":"2022","journal-title":"Ann Oncol"},{"issue":"12","key":"2025020513061038100_luaf015-B7","doi-asserted-by":"crossref","first-page":"1672","DOI":"10.1001\/jamaoncol.2024.4729","article-title":"Anti-programmed death ligand 1 plus targeted therapy in anaplastic thyroid carcinoma: a nonrandomized clinical trial","volume":"10","author":"Cabanillas","year":"2024","journal-title":"JAMA Oncol"},{"issue":"3","key":"2025020513061038100_luaf015-B8","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1089\/thy.2023.0573","article-title":"Checkpoint inhibition in addition to Dabrafenib\/Trametinib for BRAF(V600E) mutated anaplastic thyroid carcinoma","volume":"34","author":"Hamidi","year":"2024","journal-title":"Thyroid"},{"issue":"2","key":"2025020513061038100_luaf015-B9","doi-asserted-by":"crossref","first-page":"R41","DOI":"10.1530\/EJE-20-0283","article-title":"THERAPY OF ENDOCRINE DISEASE immunotherapy of advanced thyroid cancer: from bench to bedside","volume":"183","author":"Moretti","year":"2020","journal-title":"Eur J Endocrinol"},{"issue":"8","key":"2025020513061038100_luaf015-B10","first-page":"3557","article-title":"Immune profiling of thyroid carcinomas suggests the existence of two major phenotypes: an ATC-like and a PDTC-like","volume":"104","author":"Giannini","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"issue":"8","key":"2025020513061038100_luaf015-B11","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1002\/cncr.34657","article-title":"Efficacy and safety of pembrolizumab monotherapy in patients with advanced thyroid cancer in the phase 2 KEYNOTE-158 study","volume":"129","author":"Oh","year":"2023","journal-title":"Cancer"},{"issue":"16_suppl","key":"2025020513061038100_luaf015-B12","doi-asserted-by":"crossref","first-page":"e18075","DOI":"10.1200\/JCO.2024.42.16_suppl.e18075","article-title":"Dual immune checkpoint inhibition with nivolumab and ipilimumab (N + I) in patients with advanced anaplastic thyroid carcinoma (ATC)","volume":"42","author":"Sehgal","year":"2024","journal-title":"J Clin Oncol"},{"issue":"2","key":"2025020513061038100_luaf015-B13","doi-asserted-by":"crossref","first-page":"239","DOI":"10.2217\/fon.15.300","article-title":"Immunomodulatory effects of radiation: what is next for cancer therapy?","volume":"12","author":"Kumari","year":"2016","journal-title":"Future Oncol"},{"key":"2025020513061038100_luaf015-B14","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.critrevonc.2017.01.017","article-title":"The synergistic effect of radiotherapy and immunotherapy: a promising but not simple partnership","volume":"111","author":"Chajon","year":"2017","journal-title":"Crit Rev Oncol Hematol"},{"issue":"5","key":"2025020513061038100_luaf015-B15","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.aace.2021.03.003","article-title":"Anaplastic thyroid cancer successfully treated with radiation and immunotherapy: a case report","volume":"7","author":"Yang","year":"2021","journal-title":"AACE Clin Case Rep"},{"issue":"1","key":"2025020513061038100_luaf015-B16","doi-asserted-by":"crossref","first-page":"e230144","DOI":"10.1530\/ETJ-23-0144","article-title":"Combinatorial hypofractionated radiotherapy and pembrolizumab in anaplastic thyroid cancer","volume":"13","author":"Tan","year":"2024","journal-title":"Eur Thyroid J"},{"issue":"7","key":"2025020513061038100_luaf015-B17","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1089\/thy.2022.0050","article-title":"A pilot study of durvalumab (MEDI4736) with tremelimumab in combination with image-guided stereotactic body radiotherapy in the treatment of metastatic anaplastic thyroid cancer","volume":"32","author":"Lee","year":"2022","journal-title":"Thyroid"},{"issue":"11","key":"2025020513061038100_luaf015-B18","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1089\/thy.2019.0086","article-title":"A phase 2 study of pembrolizumab combined with chemoradiotherapy as initial treatment for anaplastic thyroid cancer","volume":"29","author":"Chintakuntlawar","year":"2019","journal-title":"Thyroid"},{"issue":"1","key":"2025020513061038100_luaf015-B19","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1038\/s41698-023-00449-x","article-title":"ALK fusions in the pan-cancer setting: another tumor-agnostic target?","volume":"7","author":"Shreenivas","year":"2023","journal-title":"NPJ Precis Oncol"},{"issue":"3","key":"2025020513061038100_luaf015-B20","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.cell.2014.09.050","article-title":"Integrated genomic characterization of papillary thyroid carcinoma","volume":"159","author":"Cancer Genome Atlas Research N","year":"2014","journal-title":"Cell"},{"issue":"11","key":"2025020513061038100_luaf015-B21","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1530\/ERC-19-0325","article-title":"Characterization of thyroid cancer driven by known and novel ALK fusions","volume":"26","author":"Panebianco","year":"2019","journal-title":"Endocr Relat Cancer"},{"issue":"11","key":"2025020513061038100_luaf015-B22","doi-asserted-by":"crossref","first-page":"2653","DOI":"10.1016\/j.ajpath.2018.07.012","article-title":"Mouse model of poorly differentiated thyroid carcinoma driven by STRN-ALK fusion","volume":"188","author":"Nikitski","year":"2018","journal-title":"Am J Pathol"},{"key":"2025020513061038100_luaf015-B23","doi-asserted-by":"crossref","first-page":"1009076","DOI":"10.3389\/fonc.2022.1009076","article-title":"Remarkable response to alectinib for metastatic papillary thyroid cancer with STRN-ALK fusion: a case report","volume":"12","author":"Zhu","year":"2022","journal-title":"Front Oncol"},{"issue":"6","key":"2025020513061038100_luaf015-B24","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1530\/ERC-20-0436","article-title":"Targeting EML4-ALK gene fusion variant 3 in thyroid cancer","volume":"28","author":"Aydemirli","year":"2021","journal-title":"Endocr Relat Cancer"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/3\/2\/luaf015\/61617328\/luaf015.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/3\/2\/luaf015\/61617328\/luaf015.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T13:09:05Z","timestamp":1738760945000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luaf015\/7978323"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,20]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,1,20]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luaf015","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2025,1,20]]},"article-number":"luaf015"}}