title: Individualized multimodal treatment strategy for anaplastic thyroid carcinoma-Case report of long-term remission and review of literature.
abstract: BACKGROUND
  The prognosis of anaplastic thyroid cancer (ATC) is poor with a mean survival time of six months following diagnosis. Despite various attempts to modify common treatment modalities including surgery, external beam radiation and chemotherapy, an effective treatment is not available yet. We report, here, a patient who achieved long-term survival based on multimodal treatment, including in vitro evaluation of drug response of his tumor cells.
  
  
  METHODS
  A 42 years old male patient underwent total thyroidectomy with central and lateral neck dissection for ATC (pT4b, pN0 (0/36), L0, V0, Pn1, R0 cM0 - UICC-Stage: IV b). From the tumor tissue a primary cell culture was established. While the patient received a combined radio-chemotherapy cell viability assays were performed using Sorafenib, Vandetanib und MLN8054 (Aurora kinase inhibitor) as inhibitors. Cell viability was determined by MTT-assay after 72 and 144h of treatment.
  
  
  CONCLUSIONS
  All the three compounds affected cell viability in a time- and dose dependent manner. These effects were most pronounced by Sorafenib. Based on in vitro findings, the patient was treated daily with 400mg Sorafenib for 75days. 43 months after initial diagnosis, the patient had no evidence of disease as shown by MRI, CT and FDG-PET-CT imaging.
  
  
  CONCLUSIONS
  In the setting of multimodal treatment, in vitro drug evaluation of individual tumor cells of patients might be a promising tool to ameliorate the fatal prognosis of selected ATC patients.
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany. Electronic address: seckhard@med.uni-marburg.de.
authors.forename: S
authors.initials: S
authors.lastname: Eckhardt
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Hoffmann
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
authors.forename: A I
authors.initials: AI
authors.lastname: Damanakis
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Di Fazio
authors.affiliation: Department of Nuclear Medicine, Philipps-University, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Pfestroff
authors.affiliation: Department of Nuclear Medicine, Philipps-University, Baldingerstraße, 35043 Marburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Luster
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Wunderlich
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstrasse, D-35043 Marburg, Germany.
authors.forename: D K
authors.initials: DK
authors.lastname: Bartsch
keywords: Anaplastic thyroid carcinoma; Case report; Individualized therapy; Multimodal treatment strategy; Tyrosine kinase inhibitors