Anaplastic thyroid cancer: the most aggressive and lethal type of cancer

Thyroid cancer is a common malignancy of the endocrine system. There are four types:

  • Papillary thyroid cancer is the most common of all thyroid cancers.
  • Follicular thyroid cancer accounts for 10% of thyroid cancers.
  • Medullary thyroid cancer represents 2% of thyroid cancers.
  • Anaplastic thyroid cancer is the most advanced and aggressive of the thyroid cancers. Anaplastic thyroid cancer is very rare and is found in less than 2% of patients with thyroid cancer. It is more common in patients over 60 years of age.

Given its limited incidence and the characteristics of anaplastic thyroid cancer (ATC), it is one of the diseases currently classified as rare and untreated. Therefore, at Oligofastx we are working on research with the aim of providing patients with strategies that improve their quality of life and provide therapeutic treatment.

A rapidly growing clinical picture

The usual clinical picture is a rapidly growing thyroid mass invading surrounding structures with compressive symptoms. It is often accompanied by cervical lymph node enlargement and distant metastasis.

The clinical management of ATC is challenging, as it is highly resistant to chemotherapy. The treatment regimen combines surgery, when feasible, accelerated hyperfractionated external beam radiotherapy and doxorubicin-based chemotherapy.

Lump or nodule around the thyroid gland: main symptom

Anaplastic thyroid cancer can present in several forms. Most commonly, it presents as a lump or nodule in the neck, in the thyroid gland.

The thyroid gland, a small gland measuring about 5 cm in diameter, is located under the skin of the neck, below the Adam’s apple (also called Adam’s apple). The two halves (lobes) of the thyroid gland are connected in its central part (isthmus), giving it the appearance of a bow tie. Generally, it can neither be seen nor hardly perceived. If it increases in size, it is easily palpated as a prominent lump (goiter) appearing under or on the sides of the Adam’s apple.

These tumors grow rapidly, and usually this growth may be evident to the patient or his or her family and friends. In some cases, anaplastic thyroid cancer presents as a mass in the neck causing difficulty swallowing, breathing or hoarseness if one of the vocal cords is paralyzed.

What are the causes of anaplastic thyroid cancer?

The molecular mechanisms leading to the development and progression of CAT are complex and not yet fully understood, although they are known to involve activation of the MAPK pathway, AKT/mTOR and Wnt-ß-catenin. However, the underlying mechanisms of ATC resistance to chemotherapy are not well understood.

Protein synthesis plays an important role in regulating gene expression and dysregulation of eIF4E contributes to aberrant proliferation and survival in cancer. elF4E-regulated protein synthesis in cancer cells has been described as playing an essential role in chemotherapy resistance. Overexpression of eIF4E and MAPK-interacting kinase (Mnk)-kinase correlates with poor cancer prognosis as it preferentially enhances the translation of carcinogenesis-associated mRNAs.

The Oligofastx consortium company doing research in this area is AptusBiotech.