Neoadjuvant therapy with anlotinib in a locally advanced and pulmonary metastasis PTC patient harboring TERT promoter and BRAFV600E mutations: a case report.

A 71-year-old woman with recurrent papillary thyroid carcinoma (PTC) was referred to our hospital. A computed tomography scan revealed extensive recurrence in the neck, invading sternocleidomastoid muscle, internal jugular vein, sternal end of the clavicle, strap muscle and skin; and lateral compartment and subclavian lymph nodes were also involved. Multiple pulmonary micrometastases also noticed. The tumor was considered unresectable; however, the patient was unwilling to accept highly invasive surgery. Therefore, we initiated neoadjuvant therapy with anlotinib, 12mg p.o. daily with a 2-week on/1-week off regimen. The tumor shrunk to resectable state after 4 cycles of treatment, and after 3 weeks of withdrawal, successful surgical resection without gross tumor residual was performed. Pathology confirmed as classic PTC harboring coexistent TERT promoter and BRAFV600E mutations by NGS. After anlotinib therapy, apoptosis induction was observed, and proliferation increased, which was due to three weeks of anlotinib withdraw. Structual recurrence was recorded at 6 months after operation due to no further treatment was taken. Our finding suggests that anlotinib could represent as a good treatment option for patients with locally advanced (with or without distant metastasis) PTC; Anlotinib treatment resulted in sufficient reduction of the tumor mass to enable total thyroidectomy and radioactive iodine treatment, providing long-term control of the disease.

Neoadjuvant therapy with anlotinib in a locally advanced and pulmonary metastasis PTC patient harboring TERT promoter and BRAFV600E mutations: a case report

SUMMARY A 71-year-old woman with recurrent papillary thyroid carcinoma (PTC) was referred to our hospital. A computed tomography scan revealed extensive recurrence in the neck, invading sternocleidomastoid muscle, internal jugular vein, sternal end of the clavicle, strap muscle and skin; and lateral compartment and subclavian lymph nodes were also involved. Multiple pulmonary micrometastases also noticed. The tumor was considered unresectable; however, the patient was unwilling to accept highly invasive surgery. Therefore, we initiated neoadjuvant therapy with anlotinib, 12mg p.o. daily with a 2-week on/1-week off regimen. The tumor shrunk to resectable state after 4 cycles of treatment, and after 3 weeks of withdrawal, successful surgical resection without gross tumor residual was performed. Pathology confirmed as classic PTC harboring coexistent TERT promoter and BRAFV600E mutations by NGS. After anlotinib therapy, apoptosis induction was observed, and proliferation increased, which was due to three weeks of anlotinib withdraw. Structual recurrence was recorded at 6 months after operation due to no further treatment was taken. Our finding suggests that anlotinib could represent as a good treatment option for patients with locally advanced (with or without distant metastasis) PTC; Anlotinib treatment resulted in sufficient reduction of the tumor mass to enable total thyroidectomy and radioactive iodine treatment, providing long-term control of the disease.

Do entrepreneurial orientation and intellectual capital influence SMEs' growth? Evidence from Pakistan.

This research analyzes the impacts of intellectual capital (IC) and the balancing power of entrepreneurial orientation (EO) on innovation growth (IG) in Pakistan's SME sector. A quantitative approach on smart PLS has been applied through the SEM model, backed by a survey to gather primary data from 256 participants of Pakistan's SME sector. A significant effect of human capital on Pakistani firms' IG was identified. In contrast, the effect of structural capital was determined to be insignificant over the IG of Pakistani firms. On the other hand, the customer capital's effect was also significant over Pakistani firms' innovation growth. Little moderation of EO between human capital and IG has been determined. The moderations of "EO between human capital and innovation growth" and "EO between structural capital and innovation growth" were insignificant. However, the moderation of EO between customer capital and IG was significant. The scope of this study is limited to firms in Pakistan and can be extended to firms in other regions, which can provide broad findings.

Multidimensional perspective of green financial innovation between green intellectual capital on sustainable business: the case of Pakistan.

This study investigates the multifaceted role of green innovation among green intellectual capitals (GICs) on business sustainability in Pakistan's manufacturing sector. A quantitative method based on the SEM model on SmartPLS and Stata analysis was used, which was supplemented by a survey of 800 Pakistani SME sector supply chain-associated participants. The findings revealed a significant effect of green intellectual capital and green innovation on business sustainability, while structural capital was found to have a significant moderating effect on the business sustainability of Pakistani firms. It has been determined that the relationship between GIC and BS has a strong moderation of green innovation. Furthermore, the relationship and impact of GICs on the business sustainability of Pakistani manufacturing companies were statistically significant, and green innovation played a moderating role between GIC and business sustainability. Therefore, it has been suggested that Pakistani manufacturing companies participate in eco-innovation to progress business sustainability.

Nexus between energy policy and environmental performance in China: The moderating role of green finance adopted firms.

This study measures the association between resources and the atmosphere; social and environmental aspects of energy production have become critical. In this context, the aim of this research is to explore the mediating effect of renewable energy patents in developing potential frameworks for energy policy viewpoints on the climate. The study took panel data from 2010 to 2017 and used a non-radial data envelopment analysis (DEA) process and panel data model for 30 Chinese provinces. The findings indicate that between 2010 and 2017, the average environmental efficiency index (EPI) of Chinese areas increased by 9.88%. When firms' internal variables are proxied by their commodity (revenue), the relationship term's point approximate coefficient is about 0.05. This magnitude means that a 1% rise in a company's assets will result in a 5% increase is estimated to be about 0.157, implying that a 1% rise in firm leverage is correlated with a 15.7%. Finally, based on the study results, some policy implications were proposed.

Nexus between IT capability and green intellectual capital on sustainable businesses: evidence from emerging economies.

This study aims to determine the moderating role of IT capability between green intellectual capital (GIC) and business sustainability in China's manufacturing sector. A quantitative analysis approach is applied to the primary data collected through a close-ended survey questionnaire from 1000 supply chain employees of China's manufacturing industry. Results revealed that the association and effect of GIC on the business sustainability of Chinese manufacturing companies were statistically significant, while the moderating role of IT capability between GIC and business sustainability was also found. Notably, all variables indicating GIC (i.e., green human capital (GHC), green structural capital (GSC), and green relationship capital (GRC)) affected business sustainability positively and significantly, whereas the moderation of IT capability was specific to GSC and GRC. Hence, it has been recommended to the Chinese manufacturing companies to integrate IT infrastructure in their firms to enhance business sustainability. However, this research was limited to the Chinese manufacturing sector and cannot be generalized to other sectors or countries.