An Era of Advances in Systemic Therapies for Advanced Thyroid Cancer

JCO Oncol Pract. 2024 Jul;20(7):899-906. doi: 10.1200/OP.23.00747. Epub 2024 Mar 7.

Abstract

Thyroid carcinomas comprise distinct pathologic subtypes. However, advancements in characterizing the molecular tumorigenesis of thyroid cancers have changed the treatment paradigm in the past decade. Genetic profiling has become an integral component of personalizing cancer care. Oral kinase inhibitors are currently standard-of-care therapies for progressive, radioactive iodine (RAI)-refractory differentiated thyroid carcinomas (DTCs) and medullary thyroid carcinomas (MTCs). Sorafenib, lenvatinib, and cabozantinib are multikinase inhibitors approved for patients with metastatic RAI-refractory DTC, whereas vandetanib and cabozantinib are approved for patients with MTC. Management of thyroid carcinomas has evolved such that targeted therapies have become therapeutic options for patients with BRAF, RET, NTRK, ALK, and ROS1 alterations and even have reported efficacy in anaplastic thyroid carcinomas. In this article, we review the advances made over the years in the treatment of metastatic thyroid carcinoma and focus on the systemic therapies that have recently transformed the treatment landscape of advanced disease.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Humans
  • Molecular Targeted Therapy
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use
  • Thyroid Neoplasms* / drug therapy
  • Thyroid Neoplasms* / therapy

Substances

  • Protein Kinase Inhibitors
  • Antineoplastic Agents