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The Thyroid Gland01:23

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Updated: Jul 29, 2025

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Medullary Thyroid Cancer: Updates and Challenges.

Matti L Gild1,2,3, Roderick J Clifton-Bligh1,2,3, Lori J Wirth4

  • 1Faculty of Health and Medicine, University of Sydney, Sydney 2006, Australia.

Endocrine Reviews
|May 19, 2023
PubMed
Summary

Advances in medullary thyroid cancer (MTC) management include RET testing and targeted therapies. New imaging and grading systems improve prognosis prediction and treatment for MTC patients.

Keywords:
calcitonin‌multiple endocrine neoplasiatyrosine kinase inhibitor

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Area of Science:

  • Oncology
  • Genetics
  • Radiology

Background:

  • Medullary thyroid cancer (MTC) management is complex, but recent advancements have improved patient outcomes.
  • Germline and somatic Rearranged during transfection (RET) testing have transformed treatment strategies for MTC.
  • Progress in diagnostic and therapeutic modalities has been significant over the past decade.

Purpose of the Study:

  • To review recent advancements in medullary thyroid cancer diagnostics and therapeutics.
  • To discuss the evolving paradigms in MTC management, focusing on RET alterations and targeted therapies.
  • To highlight successes and challenges in the use of kinase inhibitors for MTC.

Main Methods:

  • Review of recent literature on MTC diagnostics and treatment.
  • Analysis of the impact of Germline/somatic RET testing on MTC management.
  • Evaluation of novel imaging techniques and systemic therapies, including kinase inhibitors.

Main Results:

  • Germline and somatic RET testing have revolutionized MTC treatment options.
  • Positron emission tomography imaging and a new international grading system enhance disease characterization and prognosis.
  • Selective RET kinase inhibitors like selpercatinib and pralsetinib show improved progression-free survival and tolerability.

Conclusions:

  • Determining RET alteration status upfront is a key change in MTC management.
  • Novel evaluation techniques and targeted therapies are improving outcomes for this rare malignancy.
  • The management of medullary thyroid cancer continues to evolve with ongoing research and therapeutic development.