ArticleThe oncologist2026
Real-world outcomes and prognostic factors in anaplastic thyroid cancer: evidence from the REGETNE-Thyroid cohort.
Article in The oncologist, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAnaplastic thyroid cancer (ATC) is an extremely rare cancer with very poor prognosis. Targeted therapies have improved outcomes in selected patients, but molecular testing is often difficult because of the aggressive course, rapid clinical deterioration, and long turnaround times. This study aimed to provide real-world evidence on the management and outcomes of ATC and to evaluate the prognostic impact of molecular testing. MATERIALS AND
methodsThis multicentric, retrospective study included patients diagnosed with ATC between 1992 and 2024 from the REGETNE-Thyroid Network. Factors associated with overall survival (OS) were analyzed using Cox proportional hazards models.
results214 patients were included (median age 70.8 years; 56.5% female). Median OS was 4.5 months. Access to molecular testing (HR 0.42, p = 0.001) and BRAF V600E mutation (HR 0.50, p = 0.008) were associated with longer OS, whereas TERT promoter mutations were associated with shorter survival (HR 2.80, p = 0.014). Local surgery showed a favorable prognostic association, regardless of stage (IVa/IVb: HR 0.54, p = 0.026; IVc: HR 0.36, p < 0.001). In metastatic disease, immunotherapy (HR 0.31; p < 0.001), tyrosine kinase inhibitors (HR 0.40; p = 0.002) and their combination (HR 0.24; p = 0.001) significantly improved OS, whereas chemotherapy did not (HR 0.76; p = 0.096). Targeted therapy, used predominantly (>95%) in BRAF V600E-mutated ATC, was also associated with longer survival (HR 0.40; p = 0.001).
conclusionMolecular testing was associated with improved survival in ATC, likely driven by the identification of actionable alterations with effective targeted therapies. Local management is key in all stages. Our findings also support immunotherapy, tyrosine kinase inhibitors and their combinations as key therapeutic options.
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