Genomically Driven Precision Medicine to Improve Outcomes in Anaplastic Thyroid Cancer

Table 1

Types of thyroid cancers, prevalence, and associated genetic profiles.

Characteristics	Papillary carcinoma	Follicular carcinoma	Poorly differentiated carcinoma	Anaplastic (undifferentiated) carcinoma	Medullary carcinoma
Cell type	Follicular	Follicular	Follicular	Follicular	C cell
Prevalence (%)	80–85	10–15	<2	1-2	3–5
Typical route of spread	Local lymph-node metastasis	Hematogenous metastasis, typical to bones and lungs	Invasive local growth, lymph-node, and hematogenous metastases	Invasive local growth, lymph-node and hematogenous metastases	Lymph-node and hematogenous metastases
10-year survival (%)	95–98	90–95	~50	<10	60–80
Common mutations and prevalence (%)	BRAF 40–45; RAS 10–20; RET/PTC 10–20; TRK < 5	RAS 40–50; PAX8/PPARγ 30–35; PIK3CA < 10; PTEN < 10	RAS 20–40; TP53* 20–30; BRAF 10–20; CTNNB1* 5–10; PIK3CA 5–10; AKT1* 5–10	TP53 * 50–80; CTNNB1* 5–60; RAS 20–40; BRAF 20–40; PIK3CA 10–20; PTEN 5–15; AKT1* 5–10	Familial forms: RET > 95; Sporadic: RET 40–50; RAS 25

Gene mutations unique to poorly differentiated and undifferentiated (anaplastic) thyroid carcinomas.
Adapted from Nikiforov and Nikiforova 2011 [4].