This is a single case report, which is one of the earliest and weakest types of medical evidence. It describes one 45-year-old man with metastatic anaplastic thyroid carcinoma, a rare and aggressive cancer. He was treated with lenvatinib (20 mg daily) and pembrolizumab (200 mg every three weeks).
After 28 months, the man was still alive. Imaging showed no evidence that his cancer had progressed and no new lesions had appeared. The report notes that his tumor did not have a BRAF mutation and had high levels of a protein called PD-L1.
The report also mentions side effects: progressive wound deterioration and skin adhesion at a prior drain site. No serious side effects or treatment discontinuations were reported.
The main reason to be careful is that this is one patient. A single case cannot show that this treatment combination works for others with this cancer, or that PD-L1 levels predict who will respond. It also cannot prove the drugs caused the disease control. Larger studies are needed. Readers should talk with their own care team about their situation.
Common questions
What is anaplastic thyroid carcinoma?
Anaplastic thyroid carcinoma is a rare and aggressive type of thyroid cancer. The man in this report had metastatic disease, meaning it had spread. This case report describes his treatment and outcome, but it does not provide information about how common this cancer is or how other people respond to treatment.
What drugs were used in this case report?
The man received lenvatinib at 20 mg per day and pembrolizumab at 200 mg every three weeks. Lenvatinib is a targeted therapy and pembrolizumab is an immunotherapy. The report does not compare this combination to any other treatment, so it cannot say whether these drugs are better or worse than other options.
What side effects were reported?
The report mentions progressive wound deterioration and skin adhesion at a prior drain site. No serious side effects or treatment discontinuations were reported. Because this is a single case, these side effects may not reflect what others experience. Anyone with concerns about side effects should speak with their doctor.
Does this mean this treatment works for everyone with this cancer?
No. This is a single case report, which is one of the weakest types of evidence. It cannot show that the treatment combination works for other people with anaplastic thyroid carcinoma, or that PD-L1 levels predict response. Larger studies are needed before any general conclusions can be made.
