Regional approaches to the management of patients with advanced, radioactive iodine-refractory differentiated thyroid

Marcia S Brose1, Johannes Smit, Jaume Capdevila

  • 1Abramson Cancer Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA. brosem@mail.med.upenn.edu

Insights

For advanced, radioactive iodine-refractory differentiated thyroid cancer, expert panels found similar decision-making strategies despite regional variations. Clinical trial enrollment is preferred for managing these difficult-to-treat thyroid cancers.

Area of Science:

  • Oncology
  • Endocrinology

Background:

  • Differentiated thyroid cancer (DTC) that is refractory to radioactive iodine (RAI) presents advanced treatment challenges.
  • Current guidelines suggest clinical trials or small-molecule kinase inhibitors for RAI-refractory DTC.

Framework:

  • A multiregional expert panel convened to discuss management strategies for advanced, RAI-refractory DTC.
  • The panel evaluated regional differences in patient management and the influence of emerging therapies.

Implementation:

  • Multidisciplinary team composition varied across regions, impacting patient care approaches.
  • Despite process variations, core decision-making strategies for managing RAI-refractory DTC remained consistent among experts.

Implications:

  • Cytotoxic chemotherapy shows limited benefit, while targeted therapies are promising for RAI-refractory DTC.
  • Clinical trial enrollment is supported as the preferred treatment strategy for patients with advanced, RAI-refractory DTC.