Radioiodine Refractory Thyroid Cancer

Radioiodine Refractory Thyroid Cancer

Abstract

Over the last few decades, there has been a considerable increase in the incidence of thyroid carcinoma. Approximately 10% of patients with differentiated thyroid carcinoma (DTC), experience metastatic disease, and around half to two-thirds of these cases do not respond to radioactive iodine (RAI) therapy. Focal treatment modalities, such as thermal ablation, surgery, and external beam radiation therapy, are used to treat symptomatic lesions or lesions with a high risk of complications. However, systemic and targeted treatments are necessary when radioiodine refractoriness (RAIR) in patients with progressive disease is documented. While these treatments have demonstrated improved progression-free survival rates, they remain non-curative and can produce adverse events which may alter the quality of life. Recently, molecular testing has revealed a promising number of genomic alterations in thyroid cancer that can be targeted with specific drugs. Another alternative is the use of these drugs as a short-term treatment for tumor redifferentiation followed by RAI treatment. Additionally, the effectiveness of immunotherapy with anti-checkpoint antibodies and cytotoxic chemotherapy is also being investigated in thyroid cancer.

Overall, a comprehensive review of patient data from clinical and real-life trials is presented to provide insight into the effectiveness and safety of these treatments for patients with radioiodine-refractory thyroid carcinoma.

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