Thyroid nodule

• (Nasdaq: VCYT) today announced that new data presented at the 2023 American Thyroid Association (ATA) Annual Meeting demonstrate the type of novel molecular insights for thyroid nodules and cancer that are enabled by analysis with the Afirma Genomic Sequencing Classifier (GSC).
• Presented by clinical researchers in three posters, the findings are based on Afirma whole-transcriptome RNA sequencing data and reveal novel molecular profiles to advance research of thyroid nodules and cancer.
• Their study was based on a retrospective analysis of nearly 48,000 thyroid nodules analyzed with the Afirma GSC, confirming that the classifier identified the expected immunophenotype for a specific type of thyroid cancer molecular alteration.
• “We are excited to soon make this new tool available to the thyroid cancer research community,” said Dr. Klopper.

• A thyroid nodule is a solid or fluid-filled lump found within the thyroid.
• The majority of thyroid nodules are small, can’t be felt by touch and do not cause symptoms.
• Thyroid nodules are very common, with more than half of people scanned show small nodules.

Who gets them

• At age 30 it is estimated around 30% of women will have a nodule.
• People often find out that they have thyroid nodules during a routine check-up or when investigating another unrelated health issue.
• Thyroid nodules are readily seen on common imaging tests such as an ultrasound or CT scans.

When should you worry?

• But we now know around 10% of patients with thyroid nodules harbour cancer – so approximately 90% of those detected don’t pose a cancer risk.
• Generally, the risk is only increased with past radiation exposure, a family history of thyroid cancer, obesity, or if aged younger than 20 at the time of discovery of the nodule.
• Symptoms of concern are: an enlarging thyroid nodule, recent onset of hoarseness, difficult swallowing, neck pain or discomfort, large firm nodule or surrounding enlarged lymph nodes.

When detection leads to poorer health

• In recent decades, the dramatic increase in new cases of thyroid cancer has largely been driven by findings of small, low-risk thyroid cancers; found when investigating thyroid nodules.
• Strong evidence exists overdiagnosis – that is, a correct but unnecessary diagnosis – accounts for a large proportion of thyroid cancer cases.
• In line with this, systems for ultrasound reporting have been introduced to reduce overtreatment of small thyroid nodules.
• Read more:
  Low- and middle-income countries struggle to provide health care to some, while others get too much medicine

Take-home advice

• Investigating and treating these nodules can lead to unwarranted physical, psychological and financial consequences including overdiagnosis, overtreatment, anxiety and out-of-pocket costs.
• Patti Shih's research projects are funded by the National Health and Medical Research Council (NHMRC)

• Veracyte, Inc. (Nasdaq: VCYT) today announced that data published in Frontiers in Endocrinology provide new insights into the frequency and risk of malignancy (ROM) associated with thyroid stimulating hormone receptor (TSHR) mutations in indeterminate thyroid nodules.
• The findings, which were derived from analyses of Veracyte’s comprehensive thyroid nodule database of whole transcriptome sequencing, suggest that the use of Afirma testing could help inform diagnoses and personalized treatment decisions for patients with thyroid nodules.
• This finding, from the largest cohort of TSHR-mutated indeterminate thyroid nodules evaluated to date, suggests that Afirma testing may provide clinically meaningful risk-stratification for patients whose thyroid nodules have this mutation.”
  Dr. Shin and colleagues evaluated indeterminate thyroid nodules that had undergone Afirma GSC testing and RNA sequencing analysis, and found that 8,881 had a TSHR variant, representing 5.4% of all samples collected over the study period.
• “These findings underscore the significant potential of our expansive thyroid nodule database and whole-transcriptome capabilities to derive insights that may further enhance the ability of Afirma testing to help personalize care for patients with thyroid nodules,” said Joshua Klopper, M.D., Veracyte’s medical director, Endocrinology.

• Veracyte, Inc. (Nasdaq: VCYT) today announced that findings demonstrating the strong real-world performance of the Afirma Genomic Sequencing Classifier (GSC) were published in The Journal of Clinical Endocrinology & Metabolism (JCEM) .
• Our analysis found that the test performs just as well and on some measures better in clinical practice.
• This is incredibly encouraging and reassuring for physicians who must determine the best clinical approach for patients with indeterminate thyroid nodules.
• The Afirma Genomic Sequencing Classifier helps physicians identify patients with benign thyroid nodules among those with indeterminate FNA results, so that they may avoid unnecessary thyroid surgery.