# BRAF/MEK inhibition → surgery in anaplastic thyroid cancer

Source: https://onco.cc/pairings/braf-mek-neoadjuvant-atc/  
OnCo record `braf-mek-neoadjuvant-atc` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Shrink a BRAF-mutant anaplastic thyroid tumour with pills first, then remove what is left; some patients now survive years instead of months.

## Summary

This sequence gives the BRAF/MEK inhibitor pair dabrafenib and trametinib, often with pembrolizumab, to shrink a BRAF-mutant anaplastic thyroid cancer before surgery, then removes what remains. Anaplastic thyroid cancer can double in weeks, whereas BRAF/MEK inhibition produces responses within days, buying time for definitive local therapy. The evidence is the anaplastic cohort of the phase 2 ROAR trial plus the MD Anderson institutional series, in which previously unresectable tumours became operable and responders lived far longer than the historical expectation; there is no randomised trial because the disease is so rare. Rapid BRAF testing at diagnosis is now standard so that eligible patients can start the pills immediately.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Dabrafenib + trametinib + Surgery & Interventional
- Type: sequence
- Rationale: ATC doubles in weeks; BRAF/MEK inhibition produces responses within days, buying time for definitive local therapy.
- Evidence: Phase 2 ROAR plus institutional series; no randomised trial (rarity).

## Sources

- ClinicalTrials.gov NCT02034110: ROAR (anaplastic thyroid cancer cohort): https://clinicaltrials.gov/study/NCT02034110

## Connected records

- cancers: [Thyroid cancer](https://onco.cc/cancers/thyroid/)
- targets: [BRAF](https://onco.cc/targets/braf/)
- drugs: [Dabrafenib + trametinib](https://onco.cc/drugs/dabrafenib-trametinib/)
- institutions: [MD Anderson Cancer Center](https://onco.cc/institutions/md-anderson/)
- trials: [ROAR (anaplastic thyroid cancer cohort)](https://onco.cc/trials/roar-atc/)
- fronts: [Surgery & Interventional](https://onco.cc/fronts/surgery/)

---
JSON: https://onco.cc/api/v1/entities/braf-mek-neoadjuvant-atc.json