Evidence map›Paper›PMID 35594174›Full record

ArticleClinical cancer research : an official journal of the American Association for Cancer Research2022

Enhancing Radioiodine Incorporation into Radioiodine-Refractory Thyroid Cancer with MAPK Inhibition (ERRITI): A Single-Center Prospective Two-Arm Study.

Manuel Weber, David Kersting, Burkhard Riemann, Tim Brandenburg, Dagmar Führer-Sakel, Frank Grünwald, Michael C Kreissl, Henning Dralle, Frank Weber, Kurt Werner Schmid and 8 more

Open access · hybridAbstract readEditorial
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical cancer research : an official journal of the American Association for Cancer Research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 1 pooled it
9.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.

  1. Pooled it
  2. First-in-Human Study of [Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2025
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  17. Feasibility of Short-Term Redifferentiation in Patients with Radioactive Iodine-Refractory Metastatic Thyroid Cancer.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2025
    Article
  18. Landmark Studies in Differentiated Thyroid Cancer.Annals of surgical oncology · 2025
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 5 institutions in 3 countries.

Manuel Weber *Clinic for Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.ORCID 0000-0002-8649-5977
David Kersting *Clinic for Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.ORCID 0000-0002-8451-1830
Burkhard RiemannDepartment of Nuclear Medicine, University Hospital Münster, Münster, Germany.
Tim BrandenburgGerman Cancer Consortium (DKTK) partner site Essen, Essen, Germany.
Dagmar Führer-SakelGerman Cancer Consortium (DKTK) partner site Essen, Essen, Germany.
Frank GrünwaldDepartment of Nuclear Medicine, University Hospital Frankfurt, Frankfurt, Germany.
Michael C KreisslClinic of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany.ORCID 0000-0001-5905-6015
Henning DralleDepartment of General, Visceral and Transplantation Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Frank WeberDepartment of General, Visceral and Transplantation Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Kurt Werner SchmidInstitute of Pathology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Ken HerrmannClinic for Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Walter JentzenClinic for Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Hong GrafeClinic for Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Christoph RischplerClinic for Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.ORCID 0000-0002-5545-8487
Sarah TheurerInstitute of Pathology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Andreas BockischClinic for Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
James Nagarajah *Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York.ORCID 0000-0002-3555-0809
Wolfgang P Fendler *Clinic for Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Essen University Hospital · DEGoethe University Frankfurt · DEMemorial Sloan Kettering Cancer Center · USUniversity Hospital Magdeburg · DEUniversity Hospital Münster · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRestoration of iodine incorporation (redifferentiation) by MAPK inhibition was achieved in previously radioiodine-refractory, unresectable thyroid carcinoma (RR-TC). However, results were unsatisfactory in BRAFV600E-mutant (BRAF-MUT) RR-TC. Here we assess safety and efficacy of redifferentiation therapy through genotype-guided MAPK-modulation in patients with BRAF-MUT or wildtype (BRAF-WT) RR-TC. PATIENTS AND

methodsIn this prospective single-center, two-arm phase II study, patients received trametinib (BRAF-WT) or trametinib + dabrafenib (BRAF-MUT) for 21 ± 3 days. Redifferentiation was assessed by 123I-scintigraphy. In case of restored radioiodine uptake, 124I-guided 131I therapy was performed. Primary endpoint was the redifferentiation rate. Secondary endpoints were treatment response (thyroglobulin, RECIST 1.1) and safety. Parameters predicting successful redifferentiation were assessed using a receiver operating characteristic analysis and Youden J statistic.

resultsRedifferentiation was achieved in 7 of 20 (35%) patients, 2 of 6 (33%) in the BRAF-MUT and 5 of 14 (36%) in the BRAF-WT arm. Patients received a mean (range) activity of 300.0 (273.0-421.6) mCi for 131I therapy. Any thyroglobulin decline was seen in 57% (4/7) of the patients, RECIST 1.1 stable/partial response/progressive disease in 71% (5/7)/14% (1/7)/14% (1/7). Peak standardized uptake value (SUVpeak) < 10 on 2[18F]fluoro-2-deoxy-D-glucose (FDG)-PET was associated with successful redifferentiation (P = 0.01). Transient pyrexia (grade 3) and rash (grade 4) were noted in one patient each.

conclusionsGenotype-guided MAPK inhibition was safe and resulted in successful redifferentiation in about one third of patients in each arm. Subsequent 131I therapy led to a thyroglobulin (Tg) decline in more than half of the treated patients. Low tumor glycolytic rate as assessed by FDG-PET is predictive of redifferentiation success. See related commentary by Cabanillas et al., p. 4164.

Indexed as

Iodine RadioisotopesThyroid NeoplasmsFluorodeoxyglucose F18HumansProspective StudiesProtein Kinase InhibitorsProto-Oncogene Proteins B-rafThyroglobulinFluorodeoxyglucose F18Iodine-124Iodine-131Iodine RadioisotopesProtein Kinase InhibitorsProto-Oncogene Proteins B-rafThyroglobulin

Identifiers

PMID35594174
PMCPMC9527501
OpenAlexW4281258383

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.