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Oncocytic, focally anaplastic, thyroid cancer responding to erlotinib

¹ Department of Medicine, Robert C. Byrd Health Sciences Center & Mary Babb Randolph Cancer Center, West Virginia University, POB 9162 Morgantown, WV, 26506-9162 USA
² Departments of Biochemistry, Robert C. Byrd Health Sciences Center & Mary Babb Randolph Cancer Center, West Virginia University, POB 9162 Morgantown, WV, 26506-9162 USA
³ Department of Pathology, Robert C. Byrd Health Sciences Center & Mary Babb Randolph Cancer Center, West Virginia University, POB 9162 Morgantown, WV, 26506-9162 USA

^* To whom correspondence should be addressed.

	Abstract

Objective. To highlight the molecular findings and clinical response of a patient with rapidly progressing, focally anaplastic, oncocytic thyroid carcinoma (OTC) treated with erlotinib.

Case Summary. A 69-year-old woman with recurrent, focally anaplastic OTC was given a therapeutic trial of erlotinib, a small molecule inhibitor of epidermal growth factor receptor (EGFR). Formalin-fixed, paraffin-embedded portions of the tumor were analyzed for EGFR expression, and tumor genomic DNA was amplified by polymerase chain reaction (PCR) and subjected to EGFR mutation analysis.

Discussion. An early and dramatic response was achieved with erlotinib. The tumor was focally positive for EGFR by immunostaining and two point mutations were identified, one on exon 18 and one on exon 20 in the tyrosine kinase (TK) domain.

Conclusion. Erlotinib or other novel protein kinase pathway inhibitors should be evaluated further in patients with aggressive thyroid cancer variants, who may exhibit these and perhaps other tyrosine kinase mutations.

Key Words: anaplastic, EGFR, TKI, erlotinib, exons 18 & 20, Hürthle cell, oncocytic, thyroid cancer

First published on March 10, 2009, doi:10.1177/1078155208101212

Journal of Oncology Pharmacy Practice 2009;15:111.

A more recent version of this article appeared on June 1, 2009


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