{
  "abstract": "Introduction: Anaplastic thyroid cancer (ATC) constitutes less than 2% of thyroid cancer but accounts for up to 50% of thyroid cancer mortality, with a median survival of 3–6 months. All ATC is Stage IV at diagnosis by definition. BRAF V600E-mutant disease is the only molecularly defined subset with FDA-approved targeted therapy (dabrafenib–trametinib). We report a case in which BRAF-directed therapy enabled curative-intent surgery in a patient with Stage IVC disease. Case Report: A 68-year-old woman presented with a rapidly enlarging right thyroid mass, facial plethora and internal jugular vein thrombosis. Core biopsy and immunohistochemistry confirmed ATC; next-generation sequencing revealed a BRAF V600E, TERT promoter and TP53 “triple-hit” signature arising from a dedifferentiated papillary carcinoma. PET-CT showed an FDG-avid primary, nodal disease and bilateral lung metastases (Stage IVC). She received palliative external beam radiotherapy and chemotherapy, followed by dabrafenib plus trametinib, achieving a 70% partial response with resolution of nodal and pulmonary disease. Disease progression eight months later prompted addition of pembrolizumab, complicated by immune-related granulomatous panniculitis requiring discontinuation. Multidisciplinary review subsequently confirmed an isolated thyroid remnant with no residual nodal or distant disease, permitting total thyroidectomy with bilateral neck dissection. Results and Conclusion: Histopathology confirmed unifocal ATC with 40% treatment response, a 1 mm ancestral papillary carcinoma focus, and involved margins; disease was restaged as ypT3bN1a (Stage IVA). The patient is euthyroid on levothyroxine, receiving adjuvant radiotherapy, with BRAF-targeted therapy to resume thereafter with three-monthly surveillance imaging. This case shows that BRAF-directed dual MAPK blockade can downstage unresectable, metastatic ATC to resectable disease, transforming outcomes in a malignancy once regarded as fatal. Early BRAF testing and multidisciplinary care are essential to enable this therapeutic paradigm shift.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "name": "Floris Ann Francis"
    },
    {
      "name": "Naveen Shivappa Kannur"
    },
    {
      "name": "Vijay Pillai"
    },
    {
      "name": "Nidhi Tandon"
    },
    {
      "name": "Saurabha Kumar"
    },
    {
      "name": "Nisheena Raghavan"
    },
    {
      "name": "Subramanian Kannan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2pcxstvrk6d2k.bib",
  "cited_by": 0,
  "doi": "10.4103/trp.trp_50_26",
  "fulltext_url": "https://www.ovid.com/jnls/trap/fulltext/10.4103/trp.trp_50_26~turning-the-tide-braf-targeted-therapy-enabling-surgical",
  "id": "2pcxstvrk6d2k",
  "issns": [
    "0973-0354",
    "2250-1452"
  ],
  "landing_url": "https://doi.org/10.4103/trp.trp_50_26",
  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "2712|Thyroid Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7220851464",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Wolters Kluwer Medknow Publications",
  "ris": "https://research.draconitic.com/paper/2pcxstvrk6d2k.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T14:21:22Z",
      "native_id": "0a0ec42553c54c8aaee244f46e2e01aa",
      "source": "doaj",
      "url": "https://doi.org/10.4103/trp.trp_50_26"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Thyroid Cancer Diagnosis and Treatment",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "TURNING THE TIDE: BRAF-TARGETED THERAPY ENABLING SURGICAL DOWNSTAGING IN STAGE IVC ANAPLASTIC THYROID CANCER",
  "title_text": "TURNING THE TIDE: BRAF-TARGETED THERAPY ENABLING SURGICAL DOWNSTAGING IN STAGE IVC ANAPLASTIC THYROID CANCER",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T14:21:22Z",
  "url": "https://research.draconitic.com/paper/2pcxstvrk6d2k",
  "venue": "Thyroid Research & Practice",
  "versions": []
}