Radioiodine refractory differentiated thyroid cancer

Area of Science:

• Oncology
• Endocrinology
• Nuclear Medicine

Background:

• Differentiated thyroid cancer (DTC) is typically curable but can recur or metastasize in 15% of cases.
• A significant proportion of these patients develop radioactive iodine-refractory DTC (RR-DTC), associated with a poor prognosis.

Purpose of the Study:

• To review advancements in defining, diagnosing, and treating RR-DTC.
• To discuss the pathogenesis and future prospects for managing RR-DTC.

Main Methods:

• Literature review focusing on RR-DTC diagnosis and therapeutic strategies.
• Evaluation of imaging modalities including serum thyroglobulin, ultrasound, CT, and radionuclide molecular imaging.
• Assessment of systemic therapies such as targeted therapy, redifferentiation, gene, and immunotherapy.

Main Results:

• Improved accuracy in defining RR-DTC.
• Emerging therapeutic strategies including watchful waiting, local treatments, and various systemic therapies.
• Radionuclide molecular imaging plays a crucial role in RR-DTC evaluation.

Conclusions:

• RR-DTC remains a significant clinical challenge with a poor prognosis.
• Advances in diagnostic tools and systemic therapies show promise in altering the natural history of RR-DTC.
• Future prospects involve continued progress in targeted and immunotherapies for RR-DTC.