A step forward for precision oncology in thyroid cancer
Mené sur 153 patients atteints d'un cancer différencié de la thyroïde avec mutation BRAFV600E et réfractaire à l'iode radioactif (âge médian : 62,6 ans ; durée médiane de suivi : 17,4 mois), cet essai international de phase III évalue l'efficacité, du point de vue de la survie sans progression, et la toxicité d'un traitement combinant dabrafénib et tramétinib
Radioactive iodine-refractory differentiated thyroid cancer remains a therapeutically challenging disease despite important advances over the last decade. Multi-kinase inhibitors targeting vascular endothelial growth factor receptor (VEGFR) signaling have improved progression-free survival compared with placebo,1–3 and these inhibitors are now considered standard of care for patients with locally advanced or metastatic disease.4 However, these therapies are associated with substantial toxicity, and durable responses remain uncommon. In parallel, advances in molecular profiling of thyroid cancers have identified actionable genomic alterations that could enable more personalised treatments. Among these alterations, BRAFV600E mutations are the most common, occurring in around 60% of patients.5 Although BRAF and MEK inhibition with dabrafenib plus trametinib has transformed the management of patients with BRAFV600E-positive anaplastic thyroid cancer6 and is approved for this indication, prospective data supporting this combination in patients with differentiated thyroid cancer are scarce.7 The 2026 National Comprehensive Cancer Network guidelines only recommend dabrafenib plus trametinib in these patients after progression on previous therapies and if no satisfactory alternatives are available.8 In this context, the phase 3 trial presented by Ming Gao and colleagues in The Lancet Oncology represents an important milestone for precision oncology in thyroid cancer.
The Lancet Oncology , commentaire, 2026