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Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
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Molecular Perspectives in Radioactive Iodine Theranostics: Current Redifferentiation Protocols for Mis-Differentiated

Seza A Gulec1,2,3, Cristina Benites1,3, Maria E Cabanillas4

  • 1Miami Cancer Research Center, Miami, FL 33181, USA.

Journal of Clinical Medicine
|July 13, 2024
PubMed

Insights

Thyroid cancer

Area of Science:

  • Oncology
  • Molecular Biology
  • Nuclear Medicine

Background:

  • Thyroid cancer oncogenesis involves dedifferentiation, impacting radioactive iodine (RAI) therapy effectiveness.
  • Genomic alterations, particularly in the MAPK pathway, suppress iodine metabolism and reduce RAI's theranostic power.
  • Radioiodine-refractoriness is a significant clinical challenge in differentiated thyroid cancers.

Purpose of the Study:

  • To review current clinical protocols and strategies for redifferentiating radioiodine-refractory, mis-differentiated thyroid cancer.
  • To provide an overview of intervention strategies employed by leading institutions for managing RAI-refractory thyroid cancer.
  • To discuss the efficacy and limitations of various redifferentiation approaches.

Main Methods:

  • Review of latest clinical experiences and protocols for redifferentiating thyroid cancer.
  • Analysis of imaging techniques, thyrotropin (TSH) stimulation methods, and redifferentiation agents.
  • Discussion of institutional intervention strategies and their outcomes.

Main Results:

  • MAPK pathway modulation can potentially reverse RAI-indifference and combat refractoriness.
  • Objective responses have been observed in metastatic settings through MAPK signaling modulation.
  • Various redifferentiation protocols show promise but have associated advantages and disadvantages.

Conclusions:

  • Restoring functional differentiation is crucial for effective RAI therapy in metastatic thyroid cancer.
  • MAPK pathway modulation presents a viable strategy to overcome RAI-refractoriness.
  • Further research and optimized protocols are needed to enhance redifferentiation strategies for thyroid cancer.
Keywords:
differentiated thyroid cancergenomicsmis-differentiated thyroid cancermolecular theranosticsradioactive iodine indifferentradioactive iodine refractoryredifferentiationtheranostic potentialtheranostic powerthyroid cancer

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