Carcinoma tiroideo anaplásico (ATC)
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
| ID | DIS-THYROID-ANAPLASTIC |
|---|---|
| Tipo | Enfermedad |
| Aliaces | ATCCarcinoma anaplásico de tiroidesCarcinoma tiroideo indiferenciadoАнапластична карцинома щитовидної залози |
| Situación | reviewed 2026-04-27 | pending_clinical_signoff |
| Enfermedades | Ninguna declarada |
| Fuentes | SRC-NCCN-CNS-2025 |
Informational support. All recommendations must be verified by a qualified oncologist. Engineering checks are not clinical validation or treatment approval.
| icd_o_3_morphology | 8021/3 |
|---|---|
| icd_o_3_topography | ["C73"] |
| icd_10 | C73 |
| who_classification | WHO Endocrine Tumours 5th ed (2022): Anaplastic thyroid carcinoma |
Notas
Among the most lethal solid tumors historically — IVC by AJCC at diagnosis (any T any N M0/M1 = stage IVA/B/C). Median OS without targeted therapy 3-6 months; rapid airway compromise common. Time-critical workup: BRAF V600E status drives first-line systemic therapy and must be available within days, not weeks. ATA 2021 guideline mandates rapid IHC (VE1 antibody) + reflex sequencing. Therapy by genotype: - BRAF V600E mutant (~25–40%): dabrafenib + trametinib (ROAR basket trial — ORR ~56%, transformative); FDA approved 2018 for ATC. Often used as neoadjuvant induction → surgery → adjuvant chemoRT. - BRAF wild-type RAS / NTRK / RET targetable: selpercatinib / pralsetinib / larotrectinib / entrectinib per genotype. - BRAF/RAS/NTRK/RET wild-type: chemo-radiation (paclitaxel + RT or docetaxel + doxorubicin + RT); pembrolizumab if PD-L1+ or TMB-H. Tracheostomy decision is patient-/family-driven; some protocols defer to systemic-therapy response over upfront tracheostomy when BRAF-mutant.
Utilizado por
Relevancia terapéutica
BMA-BRAF-V600E-THYROID-ANAPLASTIC- BRAF V600E en carcinoma tiroideo anaplásico (ATC, ~25-50% de los casos): dabrafenib + trametina...
Algoritmos
ALGO-THYROID-ANAPLASTIC-1L- ALGO-THYROID-ANAPLASTIC-1L
Enfermedad
DIS-THYROID-PAPILLARY- Carcinoma tiroideo papilar (CPT)
Indicación
IND-ATC-BRAF-V600E-DAB-TRAM- IND-ATC-BRAF-V600E-DAB-TRAMIND-ATC-PACLITAXEL-CARBOPLATIN- IND-ATC-PACLITAXEL-CARBOPLATIN
Cuestionarios
QUEST-THYROID-ANAPLASTIC-1L-STUB- Carcinoma tiroideo anaplásico — primera línea
Señal de alerta
RF-ATC-BRAF-V600E-ACTIONABLE- Carcinoma tiroideo anaplásico con mutación BRAF V600E (~25-50% de ATC) — dabrafenib + tra...RF-THYROID-ANAPLASTIC-FRAILTY-AGE- Age ≥75 with ECOG ≥2 or ≥2 comorbidities — cisplatin-paclitaxel CRT poorly tolerated and...RF-THYROID-ANAPLASTIC-HIGH-RISK-BIOLOGY- Carcinoma tiroideo anaplásico con mutación del conductor accionable: BRAF V600E (~25-40% ATC; da...RF-THYROID-ANAPLASTIC-INFECTION-SCREENING- Active or latent infection requiring resolution / prophylaxis before initiating cisplatin...RF-THYROID-ANAPLASTIC-ORGAN-DYSFUNCTION- Baseline organ dysfunction precluding standard cisplatin / paclitaxel / doxorubicin chemo...RF-THYROID-ANAPLASTIC-TRANSFORMATION-PROGRESSION- Resistencia adquirida al dabrafenib + trametinib en el ATC mutante BRAF (BRAF secundario / MEK /...RF-WERNER-CONFIRMED-CARRIER- Variantes patogénicas / patogénicas probables biallélicas confirmadas en WRN (RECQL2; Wern...
Esquema terapéutico
REG-DAB-TRAM-ATC- Dabrafenib + trametinib (carcinoma tiroideo anaplásico, BRAF V600E)
Revisores
REV-DENISOVA-OLGA- {"english": "Olga Denisova", "preferido": "Olga Denisova", "sufijo": "MD", "ukrainian": "...