Unraveling the complexity of medullary thyroid cancer
| PhD ceremony: | drs. E.C. Jager |
| When: | September 10, 2025 |
| Start: | 16:15 |
| Supervisors: | prof. dr. T.P. Links, prof. dr. S. (Schelto) Kruijff |
| Where: | Academy building RUG / Student Information & Administration |
| Faculty: | Medical Sciences / UMCG |
Unraveling the complexity of medullary thyroid cancer
This thesis of Eline Jager aims to improve diagnosis and treatment of medullary thyroid carcinoma (MTC), a rare thyroid cancer. A nationwide study of MTC patients in the Netherlands (1989–2018) showed a stable incidence. The extent of primary surgery increasingly followed national guidelines, and treatments were more often performed in academic hospitals, reflecting better guideline adherence and care centralization.
A major focus is the role of PET/CT imaging. Preoperative PET/CT was valuable for detecting metastases in locoregional lymph nodes and distant sites, helping to personalize surgical plans. A new imaging method, 18F-PSMA PET/CT, showed similar sensitivity and potential for targeted therapies. The link between PET/CT results and systemic treatment response was also explored in a small patient group.
The newly developed international MTC classification system was validated, enabling more reliable risk stratification into low- and high-risk groups. The protein EZH2, linked to poorer prognosis, emerged as a potential therapeutic target.
A unique contribution is the creation of patient-specific organoids from MTC tissue. These mini-tumors maintained key biological features of the original tumors and may allow personalized testing of imaging agents and treatments.
Finally, the thesis examined side effects of external beam radiotherapy. Acute and late toxicities were common and could impact patients’ long-term quality of life.