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NCCN Guidelines for Thyroid Carcinoma V.1.2018 – Web teleconference on 10/13/17

Guideline Page Panel Discussion/References Institution Vote and Request YES NO ABSTAIN ABSENT

PAP-9, FOLL-9 and Based on the panel discussion of available data, the panel consensus was to 13 0 1 13 HÜRT-9 include dabrafenib as a treatment option for BRAF mutation-positive disease in a footnote of other small-molecule kinase inhibitors: "While not FDA approved for Internal request: treatment of differentiated thyroid cancer, commercially available small-molecule Institutional Review kinase inhibitors (such as , , , , , comment to consider the (BRAF-positive), dabrafenib (BRAF-positive) or [all are inclusion of dabrafenib category 2A]) can be considered if clinical trials are not available or appropriate.” (BRAF-positive) to the list of other small-molecule Falchook GS, et al. BRAF inhibitor dabrafenib in patients with metastatic BRAF- kinase inhibitors. mutant thyroid cancer. Thyroid 2015;25(1):71-77.

Shah MH, et al. Results of randomized phase II trial of dabrafenib versus dabrafenib plus in BRAF-mutated papillary thyroid carcinoma [abstract]. J Clin Oncol 2017;35:15_suppl, 6022-6022.

PAP-9, PAP-10, FOLL-9, Based on a review of data and discussion, the panel consensus did not support 0 12 2 13 10, HÜRT-9, 10, MEDU-7, the addition of as a systemic therapy treatment option for ANAP-2, and ANAP-A papillary, follicular, Hürthle, medullary, and anaplastic thyroid carcinoma into the Guidelines [due to insufficient available data for thyroid carcinoma]. External request: Submission from Merck & See submission for references Co. to review the enclosed data for the inclusion pembrolizumab as a systemic therapy treatment option for unresectable or metastatic microsatellite instability high (MSI-H) or deficient mismatch repair (dMMR) solid tumors that have progressed following prior treatment and have no satisfactory alternative treatment options.

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