Abstract 424: An effective treatment for recurrent and inoperable anaplastic thyroid carcinoma using sintilimab and anlotinib: A case report

Introduction: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive and rapid spreading cancers. None of the existing therapies is optimum and most ATC patients experience rapid recurrence. The median overall survival (OS) of ATC patients is about 5 months. Here, we report an ATC patient, who experienced rapid recurrence after operation, achieved OS of 9 months by applying a novel strategy of combining anti-angiogenic agent, anlotinib with immunotherapeutic drug, sintilimab. Case presentation: The female ATC patient was 78 years old. On September 24, 2019, she had total thyroidectomy of the left lobe and isthmus due to a 4.7 cm × 4.2 cm lump in the left anterior cervical region. The mass was diagnosed as anaplastic thyroid cancer (pT3Nx). Immunohistochemistry and molecular testing analysis of the tumor showed the tumor proportion score of programmed death-ligand 1 Discussion: In this case, the novel anti-angiogenic drug anlotinib was chosen because it was proven to be safe and effective in treating multiple cancers without targeted mutations. Although the patient did not have positive indicators for immunotherapy (PD-L1 negative/TMB-low), we added sintilimab for the previous evidences of synergistic effect of anti-angiogenic drugs and immunotherapy in other cancers. Anti-angiogenic drug could increase the expression of immune cell markers including PD-L1; moreover, normalized tumor vasculature could increase the infiltration of immune cells. Here, our case provides supportive evidence for using this combination in the treatment of ATC patients. Conclusion: This case showed relatively good prognosis after using anti-angiogenic agent, anlotinib, and immunotherapeutic drug, sintilimab, suggesting a new direction in treating recurrent and inoperable ATC patients, and also providing a new way for cancer patients with PD-L1 negative/TMB-low. Citation Format: Shiheng Zhang, Yuntong Liu, Jiamin Luo, Yu Fang, Tonghui Ma, Xiaoyan Zhang, Wei Guan. An effective treatment for recurrent and inoperable anaplastic thyroid carcinoma using sintilimab and anlotinib: A case report [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 424.