Both the detection and treatment of thyroid cancer have been improving. There are now multiple treatment options for most thyroid cancers, and survival rates are excellent.
One treatment option that wasn’t available 10 years ago is targeted therapy, which is especially useful for advanced thyroid cancers that haven’t responded well enough to other forms of treatment.
Next generation sequencing (NGS) is starting to be used to aid treatment of thyroid cancer. NGS is massively parallel, which makes it far faster than Sanger sequencing, which is the method that was used before. It is also able to sequence multiple portions of the genome at the same time, which older methods couldn’t do. In addition, it is accurate and sensitive in detecting genetic abnormalities.
These advantages make next generation sequencing adept at identifying specific markers in the genome of a thyroid cancer tumor. These markers – specific types of genetic alterations – can be targeted by specific treatments. This enables clinicians to devise a treatment plan that is personalized to the needs of the individual patient.
NGS’ ability to identify all relevant mutations from a single sample:
- Saves time
- Preserves tissue
- Enables clinicians and researchers to devise more precise treatments, including targeted chemotherapy
- Produces better patient outcomes
Some combinations of genetic alterations produce more aggressive tumors than others. By identifying the types of alterations that are present in a particular patient’s tumors, NGS helps clinicians predict the outcome of the patient’s disease.
NGS requires only a small sample of DNA or RNA. It can be used with any type of material – fresh or fixed slides, preserved tissue, or blood. It can provide results with a smaller sample of the lesion than would be needed for Sanger sampling, which makes it useful for detecting thyroid cancer at an earlier stage.
Next generation sequencing also detects the frequency of mutation and gene expression, which helps clinicians apply personal management of a patient’s disease. In addition, it has been shown to be a useful diagnostic tool.
A 2021 observational study looked at whether next generation sequencing was useful for patients with certain kinds of rare and hard-to-treat thyroid cancers. The key question, researchers said, was whether NGS could find enough targetable genetic alterations. Before this study, most of the research that tackled this question looked at lung cancer, not thyroid cancer.
The study found that the thyroid cancer patients who received treatment guided by next generation sequencing data had better results. But the study was preliminary. The results were not statistically significant, possibly because the sample size used was so small. Other factors also may have affected the reliability of the results. But the study helps set the stage for future research.
Using next generation sequencing to treat advanced thyroid cancer is controversial, according to the researchers in this study. There’s not yet a lot of evidence, and NGS is expensive.
However, the cost of NGS is dropping, which will make it more accessible to patients and more likely to be used in ordinary clinical settings. NGS is also getting better at finding genetic alterations that can be matched with specific treatments. It appears likely that in the future, next generation sequencing will become a more widely-used tool for diagnosing and treating thyroid cancers.