Anaplastic thyroid carcinoma (ATC)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DIS-THYROID-ANAPLASTIC |
|---|---|
| Type | Disease |
| Aliases | ATCAnaplastic thyroid carcinomaUndifferentiated thyroid carcinomaАнапластична карцинома щитовидної залози |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | 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 |
Notes
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.
Used By
Actionability
BMA-BRAF-V600E-THYROID-ANAPLASTIC- BRAF V600E in anaplastic thyroid carcinoma (ATC, ~25-50% of cases): dabrafenib + trametin...
Algorithms
ALGO-THYROID-ANAPLASTIC-1L- ALGO-THYROID-ANAPLASTIC-1L
Disease
DIS-THYROID-PAPILLARY- Papillary thyroid carcinoma (PTC)
Indication
IND-ATC-BRAF-V600E-DAB-TRAM- IND-ATC-BRAF-V600E-DAB-TRAMIND-ATC-PACLITAXEL-CARBOPLATIN- IND-ATC-PACLITAXEL-CARBOPLATIN
Questionnaires
QUEST-THYROID-ANAPLASTIC-1L-STUB- Anaplastic thyroid carcinoma — first line
Red flag
RF-ATC-BRAF-V600E-ACTIONABLE- Anaplastic thyroid carcinoma with BRAF V600E mutation (~25-50% of 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- Anaplastic thyroid carcinoma with actionable driver mutation: 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- Acquired resistance to dabrafenib + trametinib in BRAF-mutant ATC (secondary BRAF / MEK /...RF-WERNER-CONFIRMED-CARRIER- Confirmed biallelic germline pathogenic / likely-pathogenic variants in WRN (RECQL2; Wern...
Regimen
REG-DAB-TRAM-ATC- Dabrafenib + trametinib (anaplastic thyroid carcinoma, BRAF V600E)
Reviewers
REV-DENISOVA-OLGA- {"english": "Olga Denisova", "preferred": "Olga Denisova", "suffix": "MD", "ukrainian": "...