ClinicalTrials.gg
Not yet recruitingNCT07010393Updated Jun 8, 2025

Genotype-Driven Neoadjuvant Therapy for Locally Advanced Thyroid Cancer: A Real-World Cohort Study

A Phase 4 interventional study of Dabrafenib and Trametinib in Thyroid Neoplasms, sponsored by Fujian Medical University. Not yet recruiting at 1 site in China. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2025-06-08.

Sponsored by Fujian Medical University · Phase 4, Interventional, and Treatment

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Phase
Phase 4
Study type
Interventional
Enrollment
335
Allocation
Non-randomized
Ages
18 Years to 80 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 16 studies in Thyroid Neoplasms by Fujian Medical University — 7 open to participants now, 7 under way, none of them phase 3. Thyroid Neoplasms · Fujian Medical University.

Started
2025
with 3 others
Phase 4
Only one
of the 16
Registered
11th of 16
by date

Among the 16 studies in Thyroid Neoplasms by Fujian Medical University, this one is one of 4 that started in 2025, is the only one in phase 4, and was the 11th registered.

Thyroid Neoplasms

785 studies on the registry are indexed under Thyroid Neoplasms; 204 are open to participants now.

Browse Thyroid Neoplasms studies →

Open to participants now

7 of the 16 studies in Thyroid Neoplasms by Fujian Medical University are open now, in 1 country. Recruiting first, the newest first:

1 more — sign in →

By country, each count listing its studies:

All 7 open studies →

Where they have run

Who these studies take

Of the 152 Thyroid Neoplasms studies recruiting now, 96 (63%) set no upper age limit and 27 (18%) stop at 75 or younger; 37 take children under 18; 13 take healthy volunteers.

This study: 18 Years to 80 Years · all sexes · no healthy volunteers.

The full table on the hub →

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 16 studies in Thyroid Neoplasms by Fujian Medical University, or all of them as a file.
02

Study summary

This multicenter registry tests whether genomically matched neoadjuvant therapy (1-4 cycles tailored to BRAF V600E, RET fusion/mutation, isolated TERT mutation, triple-negative BRAF/RET/TERT, or ICI ± TKI) can render locally advanced, initially unresectable-or high-morbidity-thyroid cancers operable. The primary endpoint is conversion-to-surgery; key secondaries are R0/1 margin rate and 12-month event-free survival, with propensity-score weighting correcting cohort imbalances. Findings aim to define a precision-guided neoadjuvant standard for down-staging advanced thyroid tumors.

Read the detailed description

This multicenter, prospective-retrospective registry will determine whether genotype-matched neoadjuvant systemic therapy can convert locally advanced, initially unresectable or high-morbidity thyroid cancers to successful surgery. Patients receive one to four 28-day cycles of treatment chosen according to actionable genomic alterations-BRAF V600E, RET fusion, RET point mutation, isolated TERT promoter mutation, "BRT triple-negative" (wild-type for BRAF/RET/TERT), or immune-checkpoint blockade ± TKI-before reassessment by a multidisciplinary team.

Primary outcome is the conversion-to-surgery rate. Key secondary outcomes include R0/1 (margin-negative) resection rate and 12-month event-free survival, defined as absence of progression, unresectability at planned surgery, recurrence, or death. Propensity-score weighting will balance baseline differences among cohorts and permit adjusted comparisons. Results will clarify the role of targeted and immunologic agents in down-staging advanced thyroid tumors and may establish a precision-guided neoadjuvant standard of care.

03

Conditions studied

  • Thyroid Neoplasms

Browse trials for

Keywords

  • Locally Advanced
  • Neoadjuvant Therapy
  • Real-World Study
  • BRAF V600E
  • RET Fusion
  • VEGF-TKI
  • Immunotherapy
  • Conversion Surgery
  • R0 Resection
  • Precision Oncology
  • Real-World Evidence
  • Conversion Therapy
04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age ≥ 18 years at enrollment.
  2. or cytologically confirmed thyroid carcinoma that meets ≥ 1 of the following:

    • Radioactive-iodine- differentiated thyroid carcinoma (DTC)
    • Medullary thyroid carcinoma (MTC)
    • Anaplastic or poorly differentiated thyroid carcinoma (ATC/PDTC)
    • Other locally advanced / thyroid deemed incurable by surgery alone.
  3. Disease judged unresectable or entailing prohibitively high-morbidity surgery at baseline by a multidisciplinary thyroid-oncology board.
  4. Documented molecular or immunophenotype qualifying for ≥ 1 study arm:

    • BRAF V600E mutation
    • RET gene fusion
    • RET activating point mutation (e.g., M918T)
    • NTRK1/2/3 fusion
    • Isolated TERT-promoter mutation with no BRAF/RET/NTRK alterations
    • Driver-negative / VEGFR-wild type ("triple-negative")
    • expression ≥ 1 % OR progression after prior multi-kinase inhibitor (MKI).
  5. Performance Status 0-2.
  6. At least one per v1.1 / (MTC with calcitonin/CEA evaluable disease accepted).
  7. Written obtained.

Exclusion criteria

Exclusion Criteria:

  1. Untreated or symptomatic ; patients with treated, stable lesions ≥ 4 weeks and off are eligible.
  2. Pregnant or breastfeeding. Women and men of must agree to effective during study and for ≥ 120 days after last dose (≥ 180 days for men after dabrafenib/trametinib).
Terms in these criteria, in plain language(14)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

iRECIST and mRECIST

Versions of RECIST adapted to particular cases. iRECIST is for immunotherapy, where a tumour can look bigger for a while before it shrinks, so growth has to be confirmed on a later scan. mRECIST usually means the version for liver cancer (hepatocellular carcinoma), which measures only the part of a tumour that still has a blood supply.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
335 participants (estimated)

Study arms

  • Experimental
    BRAF V600E Mutation

    Dabrafenib 150 mg PO BID + trametinib 2 mg PO QD given in 28-day cycles (Day 1-28). After Cycle 4 (Day 112 ± 7) patients undergo imaging review; if previously unresectable disease becomes operable, conversion surgery is scheduled within 3 weeks. Those still unresectable continue treatment until progression/toxicity.

    Drug: Dabrafenib · Drug: Trametinib · Drug: Lenvatinib · Drug: Anlotinib · Drug: Cabozantinib · Procedure: Conversion Surgery

  • Experimental
    RET Fusion PTC

    Selpercatinib 160 mg PO BID, continuous 28-day cycles. Surgery conversion assessment at Day 112 (end of Cycle 4). Resectable cases proceed to thyroidectomy ± neck dissection; others maintain therapy per label.

    Drug: Selpercatinib · Drug: Pralsetinib · Drug: Lenvatinib · Drug: Anlotinib · Drug: Cabozantinib · Procedure: Conversion Surgery

  • Experimental
    RET Point-Mutation MTC

    Prospective cohort: selpercatinib 160 mg PO BID, 28-day cycles; Retrospective sub-cohort: historical pralsetinib 400 mg PO QD (also 28-day cycles). Cycle 4 reassessment (Day 112) for potential curative resection of residual neck disease or distant oligometastases.

    Drug: Selpercatinib · Drug: Lenvatinib · Drug: Anlotinib · Drug: Cabozantinib · Procedure: Conversion Surgery

  • Experimental
    NTRK Fusion

    Larotrectinib 100 mg PO BID in continuous 28-day cycles with multidisciplinary resectability evaluation after 4 cycles (Day 112). Eligible patients undergo surgery; non-eligible continue TRK inhibitor.

    Drug: Lenvatinib · Drug: Larotrectinib · Drug: Anlotinib · Drug: Cabozantinib · Procedure: Conversion Surgery

  • Experimental
    TERT-Only (MKI)

    Investigator-selected MKI: lenvatinib 24 mg PO QD (28-day cycle), anlotinib 12 mg PO d1-14 q21d (21-day cycle; Cycle 4 ends Day 84), or cabozantinib 60 mg PO QD (28-day cycle). Conversion-surgery review: Day 112 for 28-day regimens or Day 84 for anlotinib.

    Drug: Lenvatinib · Drug: Anlotinib · Drug: Pembrolizumab · Drug: Sintilimab · Drug: Cabozantinib · Drug: Bemosuzumab · Procedure: Conversion Surgery

  • Experimental
    Triple-Negative (driver-negative) - MKI

    Same MKI options/cycle lengths as Arm 5. Cycle 4 resectability check (Day 112 or Day 84 depending on drug). Successful conversions proceed to definitive surgery; others remain on systemic therapy.

    Drug: Trametinib · Drug: Lenvatinib · Drug: Anlotinib · Drug: Pembrolizumab · Drug: Sintilimab · Drug: Cabozantinib · Drug: Bemosuzumab · Procedure: Conversion Surgery

  • Experimental
    PD-L1 ≥ 1 % / MKI-Refractory - Immunotherapy ± MKI

    Checkpoint agents: pembrolizumab 200 mg IV q3w (21-day cycles), sintilimab 200 mg IV q3w (21 d), or domestic PD-L1 Ab bemosuzumab 900 mg IV q2w (14-day cycles). Combination option: lenvatinib 20 mg PO QD (28-day cycles) added at investigator discretion. Conversion assessment occurs after 4 cycles of the longest component being used (e.g., Day 84 for pembrolizumab; Day 112 if combined with 28-day MKI). Resectable patients undergo surgery; others continue or switch therapy.

    Drug: Lenvatinib · Drug: Anlotinib · Drug: Pembrolizumab · Drug: Sintilimab · Drug: Cabozantinib · Drug: Bemosuzumab · Procedure: Conversion Surgery

Interventions

  • 150 mg orally twice daily; ≤4 × 28-day cycles

  • 2 mg orally once daily; same duration

  • 160 mg orally twice daily; ≤4 cycles

  • retrospective, 400 mg orally once daily; ≤4 cycles

  • 24 mg orally once daily; ≤4 cycles

  • Larotrectinib 100 mg orally twice daily, continuous 28-day cycles.

  • 12 mg orally once daily; 2 weeks on / 1 week off, ≤4 cycles (alternative)

  • 200 mg IV infusion every 3 weeks; ≤4 cycles

  • 200 mg IV infusion every 3 weeks; ≤4 cycles

  • Cabozantinib 60 mg orally once daily, continuous 28-day cycles.

  • DrugBemosuzumab

    China PD-L1 antibody bemosuzumab 900 mg IV every 2 weeks (14-day cycle).

  • ProcedureConversion Surgery

    Conversion Surgery if resectable

06

What researchers measure

Primary outcomes

  1. Real-World Progression-Free Survival (rwPFS)

    Time from Cycle 1 Day 1 to the earliest date of disease progression (RECIST/iRECIST) or all-cause death.

    Time frame: Baseline to radiologic/clinical progression or death, whichever occurs first, up to 36 months

Secondary outcomes

  1. Real-World Objective Response Rate (rwORR)

    Percentage of patients with complete or partial response per RECIST v1.1 (or iRECIST for immunotherapy arms) as determined by local radiology.

    Time frame: Baseline to first documented response, assessed every 8-12 weeks, up to 24 months

  2. Pathologic Tumor Regression ≥ 50 %

    Proportion of surgical specimens showing ≥ 50 % reduction in viable tumor area compared with baseline imaging estimate.

    Time frame: At surgery

  3. R0/1 Resection Rate

    Percentage of resected participants whose final pathology shows microscopically negative (R0) or close (R1 ≤ 1 mm) margins.

    Time frame: At surgery (≈ 1-5 months after first dose)

  4. Conversion-to-Surgery Rate

    Proportion of enrolled participants who proceed to the intended curative-intent resection after completion of neoadjuvant therapy.

    Time frame: Up to 12 months from first dose

  5. Overall Survival (OS)

    Time from Cycle 1 Day 1 to death; survivors censored at last known follow-up.

    Time frame: Baseline to death from any cause, censored at 36 months

  6. Duration of Response (DoR)

    Among responders, time between initial response and subsequent disease progression or death.

    Time frame: From first documented response until progression or death, up to 36 months

  7. Incidence of Grade ≥ 3 Treatment-Related AEs

    Number and percentage of participants experiencing Grade 3 or higher adverse events per CTCAE v5.0.

    Time frame: Baseline to 30 days after last dose

  8. Quality-of-Life Change (EORTC QLQ-THY34)

    Mean change from baseline in global QoL score.

    Time frame: Baseline, pre-surgery, and 6 months post-surgery

  9. Thyroglobulin Reduction ≥ 90 %

    Proportion of differentiated-tumor participants with ≥ 90 % decrease in serum thyroglobulin from baseline.

    Time frame: Pre-surgery (≈ 4 months)

07

Study locations

1 site
08

References and documents

Individual participant data

Plan to share: Undecided — De-identified datasets will be available 6 months after primary publication via institutional repository upon reasonable request

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Jul 2025; primary completion for Dec 2027, 29 months later.

How these figures are worked out, and which studies are left out of them.

Registered
May 28, 2025
First posted
Jun 8, 2025
StartEst.
Jul 1, 2025
Primary completionEst.
Dec 31, 2027
CompletionEst.
Dec 31, 2028
Last update
Jun 8, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 8, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07010393
Responsible party
Bo Wang,MD (Director, Head of Thyroid Surgery, Principal Investigator, Clinical Professor, Fujian Medical University Union Hospital) — Principal investigator
First posted
Jun 8, 2025
Start date
Jul 1, 2025 (estimated)
Primary completion
Dec 31, 2027 (estimated)
Completion
Dec 31, 2028 (estimated)
Last update
Jun 8, 2025

Study contacts

Bo Wang Professor, MD
Contact
wangbo@fjmu.edu.cn
+13959123550
Si-si Wang, MD
Contact
WangSiSi@fjmu.edu.cn
+8618650064852

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jan 2025. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drugs tested here: Dabrafenib · Trametinib · Selpercatinib · Pralsetinib · Lenvatinib · Larotrectinib · Anlotinib · Sintilimab · Cabozantinib

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