About this study
Papillary thyroid cancer is the most common type of thyroid cancer in children and young adults. Some people with this cancer have a change in a gene called RET. This change (called a RET fusion) can make the cancer harder to treat.
The usual treatment for this cancer when patients have high-risk disease is surgery followed by I131 radioactive iodine. Thyroid cells naturally take in iodine, and this allows the treatment to work. When the thyroid cancer takes in iodine, the radioactive iodine can enter the cancer cells and destroy them.
But sometimes, especially when the cancer has spread to the lungs, the cancer cells can stop taking in iodine. When this happens, radioactive iodine treatment does not work as well. It can also lead to health problems later in life.
This study tests whether a medicine called selpercatinib can help the cancer take in more iodine so that radioactive iodine treatment works better.
People in the study will take selpercatinib for 6 months before getting radioactive iodine therapy. After the first month, doctors will do a scan to see if the cancer is taking in more iodine. After 6 months, most people will get I131 radioactive iodine therapy. They will keep taking selpercatinib for 5 more days during this treatment.
Doctors will use scans, blood tests, and physical exams to see how the cancer responds.
The main goal of the study is to find out how many patients have no signs of cancer in their lungs within 18 months after starting treatment. Researchers will also study how selpercatinib works on its own, how safe the treatments are, and whether the cancer becomes better at taking in iodine. People in the study will be followed for up to 5 years to see how long the treatment works and if it lowers the need for more radioactive iodine.
Eligibility overview
- 2–21 years old
- Has differentiated thyroid cancer that has a change in the RET gene (called a RET fusion)
- Cancer has already spread to the lungs
- Had thyroid removed by surgery