[Systemic therapies for advanced thyroid cancer - an update]

Based on phase III clinical studies, four multi-kinase inhibitors (MKI) are approved for the treatment of progressive radioiodine-refractory differentiated thyroid carcinoma (rrDTC) and medullary thyroid carcinoma (MTC) in Germany. Only recently, based on the randomized trial COSMIC-311, Cabozantinib has been approved as a second-line treatment option in advanced rrDTC. As first in-label selective RET-Inhibitor, Selpercatinib showed promising efficacy in advanced MTC (first line) with RET mutations and rrDTC (second line) with RET fusions along with fewer side effects. Changes and new approaches for the treatment of ATC have been summarised in the current ATA guidelines.