Personalized treatment for differentiated thyroid cancer: current data and new perspectives

Area of Science:

• Endocrinology
• Oncology
• Surgical Oncology

Background:

• Rising incidence of low-risk differentiated thyroid carcinoma (DTC) necessitates updated management strategies.
• Traditional treatment approaches are evolving towards more conservative and personalized options.
• Recent years have seen significant advancements in DTC diagnosis and treatment protocols.

Purpose of the Study:

• To review the shift towards risk-adapted management in DTC treatment and follow-up.
• To highlight innovations in guidelines for low-risk DTC, including surgical extent and postoperative care.
• To discuss emerging strategies like active surveillance, percutaneous interventions, and novel systemic therapies for advanced DTC.

Main Methods:

• Review of current literature and recent international guidelines on differentiated thyroid carcinoma.
• Analysis of innovations in surgical management, including extent of resection and postoperative protocols.
• Evaluation of non-surgical approaches such as active surveillance and percutaneous strategies.
• Assessment of systemic target therapies for advanced radioiodine-refractory DTC and ongoing clinical trials.
• Consideration of advancements in presurgical risk evaluation, including the role of genetics.

Main Results:

• Updated guidelines promote risk-adapted management for DTC, emphasizing personalized treatment and follow-up.
• Active surveillance is increasingly recognized as a viable option for low-risk microcarcinoma.
• Percutaneous strategies are emerging as alternatives in managing malignant thyroid disease.
• New systemic target therapies have been approved for advanced radioiodine-refractory DTC, with novel agents under investigation.
• Genetics plays a growing role in presurgical risk assessment, enabling tailored management.

Conclusions:

• A paradigm shift towards conservative, personalized, and risk-adapted management is evident in DTC.
• Innovations in surgical extent, postoperative care, active surveillance, and percutaneous techniques are refining treatment for low-risk DTC.
• Advanced DTC benefits from new systemic target therapies, with ongoing research promising further advancements.
• Improved presurgical risk stratification, particularly through genetics, is crucial for optimizing individualized cancer management and treatment choices.