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Genetic test could spare cancer patients from thyroid removal

Wes Venteicher
| Tuesday, Feb. 7, 2017, 5:09 p.m.
Dr. Yuri Nikiforov, director of UPMC’s Division of Molecular and Genomic Pathology, led the scientific team that developed the ThyroSeq genetic test.
Justin Merriman | Tribune-Review
Dr. Yuri Nikiforov, director of UPMC’s Division of Molecular and Genomic Pathology, led the scientific team that developed the ThyroSeq genetic test.

UPMC is testing a tool that could help reduce the uncertainty doctors and patients face in deciding whether to remove a thyroid after finding cancer.

A clinical trial launched Feb. 1 is enrolling about 100 patients to test a new gene-sequencing panel called ThyroSeq, according to UPMC. The panel could help distinguish between tumors that are aggressive enough to warrant removing the whole thyroid from tumors that only require partial removal, said Dr. Linwah Yip, the trial's principal investigator.

Cancer in the ear lobe-sized gland, which sits at the top of the neck and produces needed hormones, is rarely fatal, Yip said. But it is costly, and, with about 50,000 to 60,000 new diagnoses per year, it is one of the few cancers that is becoming more common, she said.

“We are looking at a cancer where most people don't die, so we really want to offer the most optimal treatment course that will maintain and preserve a decent quality of life,” she said.

The current approach to diagnosing thyroid cancer relies on ultrasound images and examinations of biopsied tissue under microscopes. Pathologists look for unusual numbers of cells, malformed cells and misshapen nuclei to identify cancer and try to figure out how aggressive it is, she said.

Based on the findings, doctors talk with patients about how much of the thyroid to remove. The gland can continue functioning after partial removal. If the whole thing is removed, patients need to take medication each day to replace the lost hormones, which help with metabolism, energy levels, weight and temperature regulation, Yip said.

About half of the time doctors do a partial removal, the cancer remains, requiring a second surgery to remove the whole gland, she said.

ThyroSeq identifies specific genetic mutations in the biopsy that indicate how aggressive the cancer is, she said. Researchers hope that the test will help reduce the rate of follow-up surgeries, reducing the risks of harm that surgeries bring and reducing costs, she said.

“We're looking to see if this is a good way to help differentiate the type of surgery we offer up front,” she said.

The trial is enrolling people locally. It is scheduled to end in November 2018. A UPMC news release says it is funded by individual donors.

Wes Venteicher is a Tribune-Review staff writer. Reach him at 412-380-5676 or wventeicher@tribweb.com.

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