Thyroid cancer immunotherapy
For most forms, surgery and radioiodine are enough. Immunotherapy is for the cases where those options run out: radioiodine-refractory, medullary and aggressive tumours.
Who needs immunotherapy with this diagnosis
Thyroid cancer is the rare case in oncology where most patients need no additional treatment. Papillary and follicular cancer, which account for the great majority of cases, respond well to surgery and radioiodine therapy and carry a favourable prognosis. There is no reason to offer those patients immunotherapy, and we do not.
The difficulties begin when radioiodine stops working. Some differentiated tumours lose the ability to take it up over time, and the main instrument drops out of play. Medullary cancer arises from C-cells rather than thyrocytes, so radioiodine does not apply to it in the first place. Anaplastic cancer grows rapidly and responds poorly to everything. These are the three situations in which immunotherapy is discussed.
So at the consultation the first things looked at are the histological type and the history of radioiodine uptake; the stage on its own says less here. A patient with advanced papillary cancer that takes up iodine well usually does not need immunotherapy; a patient with limited but radioiodine-resistant disease may.
What the immunotherapy actually does
Thyroid cells produce proteins that are almost absent from other tissues. That makes them a convenient target for a directed immune response.
Tissue-specific targets
Thyroglobulin and a number of other proteins are almost exclusive to thyroid tissue. An immune response directed against them works selectively — including on metastatic lesions, if they have kept that specificity.
Thyroglobulin and a number of other proteins are almost exclusive to thyroid tissue. An immune response directed against them works selectively — including on metastatic lesions, if they have kept that specificity.
Preparing the product
Immune cells are isolated from the patient's blood, activated outside the body and given a tumour-directed specificity. The product is prepared individually.
Immune cells are isolated from the patient's blood, activated outside the body and given a tumour-directed specificity. The product is prepared individually.
Administration and reaction
The procedure is outpatient. In the first 24 hours a slight temperature, weakness and a local reaction at the injection site are possible — the expected response to immune activation.
The procedure is outpatient. In the first 24 hours a slight temperature, weakness and a local reaction at the injection site are possible — the expected response to immune activation.
Follow-up
In differentiated forms the reference point is the thyroglobulin trend, in medullary cancer calcitonin and CEA, plus neck ultrasound and CT as prescribed. What is read is the trend over several measurements: a single value on its own says little.
In differentiated forms the reference point is the thyroglobulin trend, in medullary cancer calcitonin and CEA, plus neck ultrasound and CT as prescribed. What is read is the trend over several measurements: a single value on its own says little.
Who the method suits and how the course is arranged
Selection here is stricter than in other oncological diagnoses: the method is needed by a minority of patients.
When we discuss the method
Radioiodine-refractory differentiated tumours; medullary cancer, including rising calcitonin after surgery; anaplastic cancer as part of combined treatment; recurrent disease after repeat surgery.
When it is not needed
Papillary or follicular cancer, radically operated on and responding well to radioiodine, with low thyroglobulin. Observation and replacement therapy are enough here; additional treatment is not needed.
Contraindications
Acute infections and flare-ups of chronic ones, decompensated thyrotoxicosis or uncorrected hypothyroidism, severe concomitant disease in decompensation, pregnancy, and conditions with deliberate immunosuppression.
Replacement therapy continues
After thyroidectomy levothyroxine is taken for life on the endocrinologist's schedule, with TSH monitoring. Immunotherapy does not affect or replace that part of treatment.
Timing and follow-up
Treatment is outpatient. Since the result is assessed through tumour marker dynamics, the first meaningful assessment is possible only after several consecutive measurements — months, not weeks.
Cost
The immunorehabilitation course for tumour diseases costs from 285 000 ₽ and can be paid for in stages. A consultation with the professor costs 10 000 ₽, with the oncologist 7 000 ₽.
What to expect
In radioiodine-resistant and medullary forms the goal is to slow progression and hold on to quality of life. The method does not promise that lesions will disappear.
The centre's experience is based on groups of patients treated; there are no phase III randomized trials of this method. At the same time rare forms of thyroid cancer have almost no large trials at all — that is the general situation for this diagnosis.
The method is needed by a minority of patients with this diagnosis. If the documents show that standard treatment is working, the doctor will say so directly and will not offer a course.
Questions about thyroid cancer treatment
When is immunotherapy needed in thyroid cancer?
In aggressive, recurrent and radioiodine-refractory forms, where standard methods give a weak response. Most papillary and follicular tumours respond well to surgery and radioiodine and do not need the method.
Which forms is it most relevant for?
Medullary cancer, tumours that have lost the ability to take up radioiodine, anaplastic cancer, and metastatic disease. In these situations the standard arsenal is noticeably limited.
Can it be combined with surgery and radioiodine therapy?
Yes. Immunotherapy fits into the overall treatment plan and does not interfere with standard therapy.
How is the result assessed?
Through tumour marker dynamics — thyroglobulin in differentiated forms, calcitonin and CEA in medullary cancer — together with neck ultrasound and CT. A slowdown in marker growth counts as meaningful even if the absolute value stays raised.
What should I send before the consultation?
The histology report stating the tumour type, the surgical report, details of radioiodine therapy and scintigraphy, thyroglobulin or calcitonin dynamics, and recent ultrasound and CT with written reports.
Can I travel for treatment from another region?
Yes. The centre is in Khimki, Skhodnya, next to Moscow, and accepts patients from other regions. An initial review of documents can be done remotely — which matters especially here, where a large share of patients do not need the method.
Where to go next
Other conditions in this area
Cost of the course
Doctors in this area
Discuss your situation
Leave your contact details. Our medical coordinator will contact you shortly to answer any questions.