Efficacy of Organoid-Based Drug Screening to Guide Treatment for Locally Advanced Thyroid Cancer

Inclusion Criteria19

• \. Adult participants who have either been initially diagnosed with locally advanced thyroid cancer or have experienced persistent or recurrent thyroid cancer, including cervical nodal recurrence. Types of pathology include:
• Papillary thyroid carcinoma (PTC)
• Follicular thyroid carcinoma (FTC)
• Medullary thyroid carcinoma (MTC)
• Poorly differentiated thyroid carcinoma (PDTC)
• Anaplastic thyroid carcinoma (ATC)
• \. Evidence of extrathyroidal extension and/or locally invasive disease and deemed at risk for R2 resection by treating team on clinical and/or fiberoptic examination and/or radiographic evaluation in the primary or recurrent setting. Evidence of "at risk for R2 resection" includes:
• Vocal cord paralysis by fiberoptic examination
• Extrathyroid and/or extranodal extension on CT or MRI, including tracheal and/or laryngeal cartilage invasion, esophageal involvement, and/or involvement of perithyroid muscles (e.g. strap, sternocleidomastoid, inferior constrictor muscles) or bone involvement
• Extension into the mediastinum with visceral and/or vascular involvement
• Involvement of the carotid artery or other major vessel by 180 degrees or more
• Other factors that make the participant to be "at risk for R2 resection" may be allowed, after discussion with the study's principal investigator.
• \. There is at least one measurable lesion according to the Modified Response Evaluation Criteria in Solid Tumors (mRECIST).
• \. Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤ 2.
• \. Normal organ and bone marrow function.
• \. Adequate end-organ function (including bone marrow, coagulation, renal, liver and cardiac) 28 days prior to the study registration.
• \. Ability to swallow pills.
• \. Signed informed consent form.
• \. Expected survival time of more than 2 months.