Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2022
Selumetinib Plus Adjuvant Radioactive Iodine in Patients With High-Risk Differentiated Thyroid Cancer: A Phase III, Randomized, Placebo-Controlled Trial (ASTRA).
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01843062 (A Randomised, Double Blind Study to Compare the Complete Remission Rate Following a 5-Week Course of Selumetinib or Placebo and Single Dose Adjuvant Radioactive Iodine Therapy in Patients With Differentiated Thyroid Cancer), which is not on this map. Cited by 45 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomised, Double Blind Study to Compare the Complete Remission Rate Following a 5-Week Course of Selumetinib or Placebo and Single Dose Adjuvant Radioactive Iodine Therapy in Patients With Differentiated Thyroid Cancer
Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer.Thyroid : official journal of the American Thyroid Association · 2025Guideline
- Current evidences in poorly differentiated thyroid carcinoma: a systematic review and subsection meta-analysis for clinical decision making.Endocrine · 2024Pooled it
- Hypoxia-activated PROTAC for dual inhibition of FAK and EGFR enables synergistic mechano-chemical cancer therapy.Neoplasia (New York, N.Y.) · 2026Article
- ERK Signaling in Thyroid Cancer: Lineage Suppression, Epigenetic Reprogramming, and Theranostic Reversal.Cancers · 2026Review
- Microenvironmental Control of Thyroid Cancer Plasticity and Radioiodine Resistance.International journal of molecular sciences · 2026Review
- Radioiodine-Refractory Differentiated Thyroid Cancer: Definition, Molecular Mechanisms, and Advances in Precision Therapy.Cancer innovation · 2026Review
- A histo-clinical score to predict evolution to radioactive iodine-refractory of the follicular cell-derived thyroid carcinoma (PREDIRAIR): a single-centre, prospective, cohort study.EClinicalMedicine · 2026Article
- Molecular Mechanisms of Radioiodine Refractoriness in Differentiated Thyroid Cancer: Focus on Sodium/Iodide Symporter Dysregulation.Current issues in molecular biology · 2026Review
- The molecular mechanisms and potential therapeutic implications of the crosstalk between DNA methylation and metabolic reprogramming in thyroid cancer.Cell death discovery · 2026Review
- BRAF V600E in thyroid cancer: navigating prognostic uncertainty and therapeutic opportunity.European thyroid journal · 2025Review
- Reigniting the Flame for Redifferentiation Strategies in Differentiated Thyroid Cancers: Journey of Tyrosine Kinase Inhibitors to Renewed Radioactive-Iodine Avidity.Endocrinology and metabolism (Seoul, Korea) · 2025Article
- Clinical Advances in Thyroid Disease Assessment and Management.Journal of clinical medicine · 2025Article
- Gadd45B Deficiency Drives Radio-Resistance in BRAFCancers · 2025Article
- Defactinib with avutometinib in patients with solid tumors: the phase 1 FRAME trial.Nature medicine · 2025Article
- Redifferentiation therapy in unresectable or metastatic radioactive iodine refractory thyroid cancer: an International Thyroid Oncology Group statement.The lancet. Diabetes & endocrinology · 2025Review
- Durable Response to Redifferentiation in a Patient With MetastaticJCEM case reports · 2025Article
- GPER1/ACACB are potential target genes associated with intracranial aneurysm and vascular endothelial cell senescence.Neurosurgical review · 2025Article
- The role of external-beam radiotherapy for differentiated thyroid cancer.Japanese journal of clinical oncology · 2025Review
- Lymphatic metastasis of papillary thyroid carcinoma: mechanism and clinicopathological physiology.Frontiers in endocrinology · 2025Review
- Efficacy and safety of anlotinib in combination with ¹³¹I therapy in the treatment of distant metastatic differentiated thyroid cancer: a single-arm, phase II study.Frontiers in oncology · 2025Article
Corrections and comments
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Authors and funding
19 authors at 7 institutions in 9 countries.
Funding
Abstract
purposeSelumetinib can increase radioactive iodine (RAI) avidity in RAI-refractory tumors. We investigated whether selumetinib plus adjuvant RAI improves complete remission (CR) rates in patients with differentiated thyroid cancer (DTC) at high risk of primary treatment failure versus RAI alone.
methodsASTRA (ClinicalTrials.gov identifier: NCT01843062) is an international, phase III, randomized, placebo-controlled, double-blind trial. Patients with DTC at high risk of primary treatment failure (primary tumor > 4 cm; gross extrathyroidal extension outside the thyroid gland [T4 disease]; or N1a/N1b disease with ≥ 1 metastatic lymph node(s) ≥ 1 cm or ≥ 5 lymph nodes [any size]) were randomly assigned 2:1 to selumetinib 75 mg orally twice daily or placebo for approximately 5 weeks (no stratification). On treatment days 29-31, recombinant human thyroid-stimulating hormone (0.9 mg)-stimulated RAI (
resultsFour hundred patients were enrolled (August 27, 2013-March 23, 2016) and 233 randomly assigned (selumetinib, n = 155 [67%]; placebo, n = 78 [33%]). No statistically significant difference in CR rate 18 months after RAI was observed (selumetinib n = 62 [40%]; placebo n = 30 [38%]; odds ratio 1.07 [95% CI, 0.61 to 1.87];
conclusionPostoperative pathologic risk stratification identified patients with DTC at high risk of primary treatment failure, although the addition of selumetinib to adjuvant RAI failed to improve the CR rate for these patients. Future strategies should focus on tumor genotype-tailored drug selection and maintaining drug dosing to optimize RAI efficacy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.