Multicentric phase III trial comparing two strategies in intermediate-risk differentiated thyroid cancer patients: Systematic radioiodine administration versus decision of radioiodine treatment guided by a post-operative work-up based on serum Tg values and diagnostic RAI scintigraphy

Phase 1

• Conditions: intermediate-risk differentiated thyroid cancer patients; MedDRA version: 24.0Level: PTClassification code: 10033701Term: Papillary thyroid cancer Class: 100000004864; MedDRA version: 21.1Level: PTClassification code: 10016935Term: Follicular thyroid cancer Class: 100000004864; MedDRA version: 21.1Level: PTClassification code: 10066474Term: Thyroid cancer Class: 100000004864; Therapeutic area: Diseases [C] - Neoplasms [C04]

• Registration Number: CTIS2024-514603-34-00
• Lead Sponsor: Centre Francois Baclesse

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2024-05-22
• Last Update Posted: 22 July 2024

Recruitment & Eligibility

• Status: ot Recruiting
• Sex: All
• Target Recruitment: 476

Inclusion Criteria

•Subgroup of patients with differentiated thyroid cancer and intermediate-risk defined as follows according to TNM 2017: oPapillary thyroid cancer (PTC) without aggressive subtype, follicular thyroid cancer (FTC) (with < 4 foci of vascular invasion) or Hürthle cell carcinoma (HCC) oT1b or T2 with minimal extra-thyroid extension into the perithyroidal soft tissues and/or pN1 with largest nodal dimension between 2 and 10 mm, without extra-capsular invasion and with a number of metastatic nodes = 10 oT1aN1 with largest nodal dimension between 2 and 10 mm, without extra-capsular invasion and with a number of metastatic nodes = 10, •Signed informed consent form, •Patient who agrees to be followed annually during 5 years, •Patient affiliated to the French social security system, •Patient treated by total thyroidectomy with macroscopically complete tumor resection (R0 or R1) ± neck dissection, •Total thyroidectomy performed within 6 to 14 weeks before randomization, •Patient with or without anti-thyroglobulin antibodies (TgAb), •No known distant metastases, •Normal post-operative neck ultrasound (US) or if doubtful US, negative cytology and normal Tg value (<10 ng/ml) in FNA washout fluid, •Post-operative LT4 treatment initiated at least 6 weeks before randomization, •Performance Status 0 or 1, •Patients aged 18 years or older

Exclusion Criteria

•Patients with: omedullary or anaplastic thyroid cancer oor poorly differentiated carcinoma oor well differentiated FTC with at least 4 foci of vascular invasion oor PTC with aggressive variants (tall cell or columnar cell carcinoma, diffuse sclerosing papillary, hobnail variant) oNIFTP (Noninvasive follicular thyroid neoplasm with papillary-like nuclear features), •History of malignancy in the past 3 years, except skin cancer excluding melanoma, carcinoma in situ of the cervix. Any other solid tumor or lymphoma (without bone marrow involvement) must have been treated and not have shown signs of recurrence for at least 3 years, •Low-risk or high-risk DTC patients according to ATA 2015, and intermediate-risk patients with extra-thyroid extension into the perithyroidal muscles (pT3b according to pTNM 2017), and/or pN1 with nodal largest dimension >10 mm or with extra-capsular invasion or more than 10 metastatic nodes. This excludes the following patients: oAll pT3 or pT4 opT1aN0/x with or without minimal extra-thyroid extension opT1bN0/x, pT2N0/Nx without minimal extra-thyroid extension opT1aN1 or pT1bN1 or pT2N1 without extra-thyroid extension and with nodal largest dimension <2mm opT1aN1 or pT1bN1 or pT2N1 without extra-thyroid extension and with nodal largest dimension >10mm oSurgery considered as macroscopically incomplete (R2), •Patients who have undergone lobectomy only, •Post-operative neck US with metastatic lymph-nodes confirmed by cytology or by increased Tg (>10 ng/ml) in FNA washout fluid, •Drugs affecting thyroid function including iodinated contrast agents in the 6 weeks prior to randomization. Amiodarone should have been stopped at least 1 year before randomization., •Previous RAI treatment for thyroid cancer, •Pregnant or lactating women, •Any associated geographical, social or psychopathological condition that could compromise the patient's ability to participate in the study, •Patient deprived of liberty or placed under the authority of a tutor

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified