Related Experiment Video
Updated: May 17, 2026

Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer
Published on: June 9, 2023
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
Abstract:
For patients with advanced, radioactive iodine-refractory differentiated thyroid cancer, current treatment guidelines recommend clinical trial enrollment or small-molecule kinase inhibitor therapy. However, details of patient management vary between countries depending on trial availability and national regulatory policies. Insufficient clinical trial data and variable disease characteristics challenge the creation of universal guidelines, and treatment plans often reflect regional influences. A multidisciplinary, multiregional panel of experts met to discuss regional approaches to managing patients with advanced, radioactive iodine-refractory differentiated thyroid cancer and the potential impact of emerging therapies on current treatment strategies. Despite process-oriented regional differences, the decision-making strategies were similar. Multidisciplinary teams used to manage high-risk patients varied in composition across regions, particularly regarding the responsible physician's specialty. Cytotoxic chemotherapy was viewed as limited in clinical benefit, and targeted agents as attractive, based on promising data. Panel members support clinical trial enrollment as the preferred treatment strategy for managing these patients.
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.
Related Concept Videos
Hyperthyroidism II: Pathophysiology
Graves Disease II: Pathophysiology

