9
Recommendation 4
➤ Once ATC diagnosis is considered, assessment of BRAF
V600E
mutation should be expeditiously performed by IHC and confirmed/
expeditiously assessed by molecular testing. (S-M)
Recommendation 5
➤ Molecular profiling should be performed at the time of ATC diagnosis
to inform decisions related to the use of targeted therapies,
especially as there are now FDA-approved mutation-specific therapies
in this context. (S-M)
Initial Evaluations
Recommendation 6
➤ Initial radiological tumor staging should include cross-sectional
imaging, in particular, CT neck, chest, abdomen, and pelvis with
contrast (or MRI), and, if available, FDG PET/CT. Contrast-enhanced
imaging of the brain (MRI preferred) should also be performed, if
clinically indicated. (S-M)
Good Practice Statement 1
➤ In the event that biopsy of a suspected metastatic disease site is
clinically indicated, primary management of ATC should not be
delayed until biopsy is obtained. (GPS)
Good Practice Statement 2
➤ All critical appointments and assessments that are required before
primary treatment of ATC should be prioritized and completed as
rapidly as possible. (GPS)
Recommendation 7
➤ Every patient with ATC should undergo evaluation of the vocal cords at
initial presentation, and thereafter based upon changing symptoms.
(S-L)
Diagnosis
