{"entity":{"id":"braf-mek-neoadjuvant-atc","kind":"pairing","name":"BRAF/MEK inhibition → surgery in anaplastic thyroid cancer","aka":[],"tldr":"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.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT02034110: ROAR (anaplastic thyroid cancer cohort)","url":"https://clinicaltrials.gov/study/NCT02034110"}],"tags":[],"related":[],"cancers":["thyroid"],"sections":[],"technologies":[],"targets":["braf"],"drugs":["dabrafenib-trametinib"],"companies":[],"institutions":["md-anderson"],"pathways":[],"terms":[],"trials":["roar-atc"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"dabrafenib-trametinib","b":"surgery","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).","pairingType":"sequence"},"route":"/pairings/braf-mek-neoadjuvant-atc/","neighbours":{"cancer":[{"id":"thyroid","kind":"cancer","name":"Thyroid cancer","route":"/cancers/thyroid/"}],"target":[{"id":"braf","kind":"target","name":"BRAF","route":"/targets/braf/"}],"drug":[{"id":"dabrafenib-trametinib","kind":"drug","name":"Dabrafenib + trametinib","route":"/drugs/dabrafenib-trametinib/"}],"institution":[{"id":"md-anderson","kind":"institution","name":"MD Anderson Cancer Center","route":"/institutions/md-anderson/"}],"trial":[{"id":"roar-atc","kind":"trial","name":"ROAR (anaplastic thyroid cancer cohort)","route":"/trials/roar-atc/"}],"section":[{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}]}}