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Christine Do Cao1, Antoine Danais1, Paul Schwartz2

  • 1Département d'endocrinologie, de diabétologie et de métabolisme, CHU de Lille, F-59000, Lille, France.

Bulletin Du Cancer
|November 6, 2024
PubMed
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Radio-iodine refractory differentiated thyroid cancer (RAIR DTC) requires specialized care. New targeted therapies and proactive management significantly improve outcomes for advanced thyroid cancer patients in 2024.

Area of Science:

  • Oncology
  • Endocrinology
  • Nuclear Medicine

Background:

  • Differentiated thyroid cancer (DTC) can become refractory to radioiodine (RAIR), affecting 5-10% of patients.
  • RAIR DTC presents with advanced or recurrent disease, including invasive cervical disease and distant metastases.
  • Conventional treatments like surgery and radioactive iodine are ineffective for RAIR DTC, necessitating multidisciplinary management.

Purpose of the Study:

  • To review the current management strategies for RAIR DTC.
  • To outline therapeutic options available for RAIR DTC in 2024.
  • To discuss advancements in treating advanced thyroid cancer.

Main Methods:

  • Review of epidemiological data for RAIR DTC.
  • Analysis of local ablative treatment modalities for metastatic lesions.
Keywords:
Cancer thyroïdien réfractaire à l’iodeInhibiteurs de tyrosine kinaseLoco-regional treatmentSystemic treatmentThyroid cancer radio-iodine refractoryTraitement locorégionalTraitement systémiqueTyrosine kinase inhibitor

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  • Evaluation of molecular testing and systemic therapy selection.
  • Discussion of tyrosine kinase inhibitors (TKIs) and other targeted treatments.
  • Assessment of side effect management and systemic strategies.

    • Main Results:

    • Substantial progress has been made in managing RAIR DTC over the last decade.
    • Targeted therapies, including TKIs, offer improved outcomes for advanced thyroid cancer.
    • Some targeted treatments can re-establish radioactive iodine uptake in RAIR DTC.
    • Proactive management of TKI side effects is crucial for patient care.

    Conclusions:

    • RAIR DTC management remains challenging but has seen significant improvements.
    • Multidisciplinary expert care is essential for patients with RAIR DTC.
    • Advancements in systemic therapies and targeted treatments offer better prognoses for advanced thyroid cancer.