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Background:Pediatric papillary thyroid cancer (PTC) typically presents with more advanced disease as compared with adults, yet the prognosis, even in the presence of distant metastatic disease, is usually excellent. Systemic therapies other than radioactive iodine (RAI) are rarely required. Sorafenib is an orally administered multi-kinase inhibitor that has shown promise in the treatment of adults with advanced thyroid cancer, but it has not yet been studied in children with this disease.Objective:Our objective is to present an adolescent with a progressive RAI-resistant PTC who was successfully treated with sorafenib.Patient and Intervention:A 14-year-old girl had progressive lung metastases from PTC despite previous therapies with almost 400 mCi 131I. Sorafenib was initiated at a starting dose of 200 mg twice daily and decreased to a maintenance dose of 200 mg daily due to side effects that developed within 3 weeks of treatment. After 67 days on the lower dose, there was a dramatic improvement in the lung metastases. The patient was monitored while continuing thyrotropin-suppressive therapy only. Minimal regrowth of the pulmonary metastases was observed, and a second treatment course of sorafenib 200 mg every other day was equally successful in achieving a clinical response. Thyroglobulin autoantibodies declined over the course of therapy and observation.Conclusion:In the very rare case of the pediatric patient with progressive RAI-refractory PTC, for which no good systemic therapy exists, sorafenib may play an important role in the management of this disease. [ABSTRACT FROM AUTHOR]

The objective of this phase II trial was to investigate the safety and efficacy of autologous heat shock protein‐peptide complex 96 (HSPPC‐96) vaccines prepared from tumor specimens of patients with newly diagnosed or previously treated indolent non‐Hodgkin lymphoma (NHL).The study was for patients with indolent B‐cell NHL with measurable lesions. HSPPC‐96 vaccines were prepared from patients' resected tumor specimens and administered as a 25‐μg intradermal injection in the absence of disease progression every week for 4 weeks and then every 2 weeks until the vaccine supply was exhausted.Twenty patients were enrolled in this trial. The median patient age was 59 years. Ten patients had been treated previously (median, 2 regimens; range, 1 to 7). Eighteen (90%) patients had stage III or IV disease. Autologous vaccines were successfully prepared for 17 (85%) patients and all received at least 1 dose. The treatment was very well tolerated. One patient experienced a response with biopsy‐proven clearance of the lymphoma cells in 2 of the skin nodules at 3.0 months that lasted for 7.0 months. Eight patients had stable disease for 6.0 to 19.8 months. The median failure‐free survival duration in patients who received vaccine therapy was 5.2 months.HSPPC‐96 can be prepared from tumor specimens for the majority of lymphoma patients, but it had limited efficacy in inducing responses in patients with active diseases. Further studies of HSPPCs, therefore, should be considered in adjuvant settings or in combination with other immunomodulatory agents to assess survival benefit. Cancer 2007. © 2006 American Cancer Society. [ABSTRACT FROM AUTHOR]