Application Detail

Status

Closed

Description of Medical Service

Recombinant human thyroid-stimulating hormone (thyrotropin alfa-rch) is used as a component of a diagnostic test for recurrence of thyroid cancer.

Patients who have had well-differentiated thyroid cancer and who have been successfully treated by surgical removal of the thyroid gland (thyroidectomy), followed by treatment with radioactive iodine, require monitoring for recurrence of thyroid cancer by the detection of thyroid tissue following treatment. Patients who have had thyroidectomy are typically treated with synthetic thyroid hormone therapy (THT) to replace the thyroid hormone that would otherwise have been produced by the patient’s thyroid gland.

Recurrence of thyroid cancer is assessed by measurement of serum thyroglobulin, a protein that is only produced by thyroid gland tissue. Thyroglobulin testing can be performed in conjunction with a radioactive iodine whole body scan. In order to increase the sensitivity of these tests for the recurrence of thyroid cancer, the release of thyroglobulin and the uptake of radioactive iodine by thyroid tissue can be promoted by increasing the patient’s thyroid stimulating hormone (TSH) levels. This can be achieved by having the patient discontinue their THT, in order to stimulate the production of their own TSH, or by the administration of another form of TSH, such as recombinant human thyroid-stimulating hormone.

Description of Medical Condition

Thyroid cancer, although relatively rare, is the most common endocrine neoplasm (cancer of hormone-producing tissue). Thyroid cancer affects women more commonly than men and the majority of cases occur between ages 25 and 65.

There are three main forms of thyroid cancer: well differentiated, medullary, and anaplastic (or poorly differentiated). The well-differentiated form accounts for approximately 80-90% of all thyroid cancers. Well-differentiated thyroid cancer is generally regarded as slow-growing with the potential for prolonged remission, with relatively good long-term survival rates for most patients with definitive primary (initial) treatment who comply with ongoing monitoring.

Reason for Application

-

Medical Service Type

-

Previous Application Number

Not Applicable

Associated Documentation

Application Form

-

PICO Confirmation

13-14 April 2011
Final DAP 1156 - Diagnostic use of Thyrotropin alfa-rch for Patients with Well-Differentiated Thyroid Cancer (PDF 411 KB)

Assessment Report

15 October 2011
Assessment Report (PDF 12,479 KB)

Public Summary Document

MSAC appraised this assessment on 29 March 2012.
Public Summary Document (PDF 64 KB)

Meetings for this Application

PASC

17 February 2011
13-14 April 2011

ESC

9 - 10 February 2012

MSAC

29 March 2012