case_images: PMC8024690_01
case_images: Treatment prior to anlotinib therapy. (A) Timeline of treatment prior to clinical study, including four operations in the neck, two sessions of RAI therapy and TSH suppression therapy with L-T4. (B) Functional iodine uptake was observed in the neck on the initial post-treatment whole-body scan. (C) No functional iodine uptake was observed in the neck on the second post-therapy whole-body scan, but an abnormal radioactive iodine uptake foci in anterior-inferior mediastinum. (D) Abnormal radioactive iodine uptake foci in anterior-inferior mediastinum was confirmed to be external contamination by change clothes. (E) Papillary thyroid carcinoma was confirmed pathologically with specimen from the 4th operation (HE stain, x200) after RAIR-DTC was developed, and Ki67 stain revealed about 10% positive rate. Tg, Thyroglobulin; TSH, Thyroid Stimulating Hormone; L-CND, Left-Central Neck Dissection; L-LND, Left-Lateral Neck Dissection; RAI, Radioactive Iodine.
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case_images: PMC8024690_01_fonc-11-626076-g0001.jpg
case_images: F1
case_images: Treatment prior to anlotinib clinical trial is summarized in the following figure (Figure 1).
case_images: Tumor shrinkage during placebo and anlotinib therapy. (A) Imaging evaluation on target and non-target lesions, including placebo therapy (baseline, C2, C8) and anlotinib therapy (baseline, C2, C8, C16, and C52). ((1): Tumor under the right subclavian; (2): Tumor in front of the right sternocleidomastoid muscle; (3): Tumor behind the left scapula; (4): Tumor in front of larynx and tumor in the cervical sheath; (5): Metastatic tumor of the left lung). Red Arrow: tumor. (B) Tumor shrinkage per review (Evaluation was performed before C12 in every two cycles and after C12 in every four cycles).
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case_images: F2
case_images: Progression occurred at C8 with placebo treatment (Figure 2A). So far, this patient has been treated with 52 cycles of anlotinib at the time of manuscript preparation, with a reduction of 93.79% in the target lesions, and no new lesions emerged (Figure 2A). Tumor shrinkage during placebo and anlotinib therapy are shown in figure below (Figure 2B).
case_images: TSH suppression therapy during anlotinib treatment. (A) Change of serum TT4 and FT4 during placebo and anlotinib therapy (Yellow dotted line: upper limit of FT4, Normal range: 12-22 pmol/L; Red dotted line: upper limit of TT4, Normal range: 66-181 nmol/L). (B) Change of serum TSH and Tg during placebo and anlotinib therapy (TSH normal range: 0.27-4.2 muIU/mL; Tg normal range: 3.5-77 ng/mL).
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case_images: PMC8024690_01_fonc-11-626076-g0003.jpg
case_images: F3
case_images: TSH suppression therapy with L-T4 was continued during anlotinib therapy (Figure 3).