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BRAF V600E Mutation Ups Papillary Thyroid Cancer Death

Retrospective multicenter study shows PTC-related mortality increased with mutation
TUESDAY, April 9 (HealthDay News) -- For patients with papillary thyroid cancer (PTC), the presence of the BRAF V600E mutation is associated with increased cancer-related mortality, according to a study published April 10 in the Journal of the American Medical Association.
Mingzhao Xing, M.D., Ph.D., from Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a retrospective study of 1,849 patients (median age, 46 years) with PTC from 13 centers in seven countries to examine the correlation between BRAF V600E mutation and PTC-related mortality.
During a median follow-up of 33 months, the researchers found that mortality was significantly increased in BRAF V600E-positive versus mutation-negative patients (5.3 versus 1.1 percent, respectively). In the analysis of all PTC, there were 12.87 deaths per 1,000 person-years for BRAF V600E-positive patients versus 2.52 for mutation-negative patients (hazard ratio, 2.66 after adjustment for age at diagnosis, sex, and medical center). In analysis of the conventional variant of PTC, there were 11.80 deaths for 1,000 person-years for BRAF V600E-positive patients versus 2.25 for mutation-negative patients (adjusted hazard ratio, 3.53). The correlation between BRAF V600E with PTC mortality was no longer significant for all PTC after adjustment for lymph node metastasis, extrathyroid invasion, and distant metastasis.
"In this retrospective multicenter study, the presence of the BRAF V600E mutation was significantly associated with increased cancer-related mortality among patients with PTC," the authors write. "Because overall mortality in PTC is low and the association was not independent of tumor features, how to use BRAF V600E to manage mortality risk in patients with PTC is unclear."
Several authors disclosed financial ties to the pharmaceutical industry. Two of the authors reported receiving royalties as co-holders of a licensed U.S. patent related to BRAF V600E mutation in thyroid cancer.
Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1677371 )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1677371 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1677354 )
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