Vemurafenib and Cobimetinib for the Treatment of Patients With High Risk Differentiated Thyroid Carcinoma With BRAFV600E Mutation

Inclusion Criteria: * Documented informed consent of the participant and/or legally authorized representative * Willingness to be followed for about 14 months * Males or females aged ≥ 18 years at the time of informed consent * Patients with thyroid carcinoma of follicular origin (papillary, follicular or Hurthle cell) * Known positive BRAFV600E mutation (determined on a previous analysis and/or on a representative formalin-fixed paraffin embedded (FFPE) tumor samples or on a biopsy sample) * High risk for recurrence according to the American Thyroid Association (ATA) guideline defined as having one or more of the features below: * Gross extrathyroidal extension * FTC with extensive vascular invasion (\> 4), although less likely to have BRAF mutation * PTC with vascular invasion * Advanced nodal disease of (any node \>3 cm, \> 4 nodes, or extra-nodal extension) * BRAF+TERT promoter mutation * Post op thyroglobulin (TG) suggestive of distant metastasis * Distant metastatic sites (only for exploratory arm) * Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 * Blood pressure (BP) ≤ 140/90 mm Hg at screening with or without antihypertensive medications and no change in antihypertensive medications within 1 week prior to treatment start * Creatinine clearance ≥ 50 mL/min according to the Cockcroft and Gault formula * Absolute neutrophil count (ANC) ≥ 1.5 x 109/L * Hemoglobin ≥ 9.0 g/dL * Platelet count ≥ 100 x 109/L * Normal blood coagulation f…