lack of response

Anaplastic Thyroid Cancer is a very aggressive disease. The investigators believe that angiogenesis is very important for these tumors to progress. Preclinical data is suggesting this. This is why we we prospectively want to treat these patients with avastin (and doxorubicin). However, local control is of major concern. Therefore, patients are initially treated with hyperfractionated radiotherapy and undergo surgery. Then they can enter this study.

Patients with Anaplastic Thyroid Cancer have a poor prognosis. We will treat the patients initially with our standard radiochemotherapy, which consists of doxorubicin 20mg fixed dose/week and hyperfractionated radiotherapy 1,6 Gy twice daily up to 46 Gy in total. The first week during radiotherapy, they will also receive Avastin 15mg/kg. 1-2 weeks after radiotherapy patients will undergo surgery of their primary tumor. After this "standard" therapy patients can be included in this study. Treatment is 20 mg fixed dose doxorubicin q1w and avastin 15mg/kg q3w. Treatment will continue maximum 6 months or until progress or until intolerable side effects occur.

Inclusion Criteria:

• cytologically or histologically verified anaplastic thyroid cancer
• completed standard therapy
• operated with R0 or R1 surgery
• Performance Status 0-2 (if pulmonary mets PS 0-1)
• normal wound healing
• neutrophils > 1,5 million/ml
• platelets > 100 million/ml
• bilirubin < 2 ULN
• creatinin < 150mikromol/L

Exclusion Criteria:

• PS 3-4 (if pulmonary mets 2-4)
• R2 resection of primary tumor