OnCo
cancersCancer

Thyroid cancer

Thyroid cancer is usually curable with surgery and radioactive iodine, the original theranostic. Rare aggressive forms respond to RET and BRAF inhibitors.

Thyroid cancer is really several diseases. Differentiated thyroid cancer (papillary ~85%, follicular, oncocytic) arises from follicular cells, retains iodine uptake, and has a 10-year survival above 95%; its incidence has tripled in many countries because ultrasound finds tiny tumours that would never have caused harm. Medullary thyroid cancer comes from calcitonin-producing C cells, is driven by RET mutations (hereditary in MEN2), and does not take up iodine. Anaplastic thyroid cancer is rare, dedifferentiated, and historically fatal within months.

Differentiated disease is treated by surgery, with radioactive iodine (the first theranostic, 1946) reserved for intermediate and high-risk patients after HiLo, ESTIMABL2, and IoN showed low-risk patients gain nothing from it; active surveillance is accepted for microcarcinomas, and lobectomy suffices for many. When cancer becomes radioiodine-refractory, lenvatinib (SELECT) and sorafenib (DECISION) extend progression-free survival, and genotype directs selective therapy: selpercatinib for RET fusions, larotrectinib for NTRK, dabrafenib-trametinib for BRAF. Medullary cancer moved from vandetanib and cabozantinib to RET-selective selpercatinib after LIBRETTO-531 (2023). Anaplastic cancer with BRAF V600E responds to dabrafenib-trametinib (ROAR), often enabling surgery, and triplets with pembrolizumab are producing multi-year survivors.

The field's biggest problems are the opposite of most cancers': over-detection and over-treatment of indolent disease, alongside the unsolved lethality of anaplastic and RAI-refractory disease, resistance to RET inhibitors (solvent-front mutations), and the toxicity of long-term multikinase therapy.

State of the art today

  • Genotype-directed therapy for aggressive subtypes.
  • De-escalation is the story: radioiodine omitted for low-risk disease (ESTIMABL2, IoN), low-dose ablation when needed (HiLo), lobectomy and active surveillance for small tumours.
  • Genotype-directed therapy covers most aggressive disease: RET (selpercatinib beat multikinase inhibitors head to head), BRAF, NTRK, ALK.
  • Molecular classifiers on needle biopsies have halved diagnostic surgery for indeterminate nodules.
  • Redifferentiation with MAPK inhibitors can restore radioiodine uptake in about half of refractory patients.
Show survival figures (1)

Averages across everyone diagnosed, often years ago. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.

  • Anaplastic thyroid cancer with BRAF V600E has moved from a median survival under six months to 15 months with the doublet and longer with immunotherapy added, and neoadjuvant use enables surgery.
Who it affects
Show survival figures (1)

Averages across everyone diagnosed, often years ago. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.

  • ~820,000 cases per year; most are indolent papillary cancers with >98% survival.

Where the cases are

Cases by country · GLOBOCAN 2022
All countries →

Site: Thyroid. World: 821,214 new cases, 47,507 deaths.

#CountryNew casesDeaths
1China466,11811,564
2United States of America52,1692,244
3Brazil31,3851,103
4India21,8735,455
5Korea, Republic of17,642414
6Japan16,4192,193
7Russian Federation16,145987
8Türkiye15,376867
9Indonesia13,7612,141
10Mexico11,392993

Standard of care

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Differentiated

Thyroidectomy ± radioactive iodine; TSH suppression.

NCCN Guidelines: Thyroid Carcinoma
Radioligand therapy (beta emitters)
Advanced/refractory

Lenvatinib; selpercatinib (RET); BRAF/MEK (anaplastic).

NCCN Guidelines: Thyroid Carcinoma
Selpercatinib
Nodule work-up

Ultrasound with TI-RADS; FNA only for nodules meeting size/appearance thresholds; Bethesda reporting; molecular classifier (Afirma, ThyroSeq) for indeterminate results.

NCCN · 2A
Thyroid nodule FNA, Bethesda cytology & molecular classifiersUltrasoundBethesda category (thyroid cytology)
Papillary microcarcinoma (≤1 cm, no spread)

Active surveillance or lobectomy; total thyroidectomy and radioiodine not indicated.

NCCN · 2A
Active surveillance of papillary microcarcinomaUltrasound restraint and surveillance to reverse thyroid cancer overdiagnosis
Low-risk differentiated (pT1-T2 N0)

Lobectomy or total thyroidectomy; no radioiodine ablation (ESTIMABL2, IoN); modest TSH suppression then normal-range TSH.

NCCN · 2A
ESTIMABL2IoNLow-risk differentiated thyroid cancer (ATA risk)TSH suppression
Intermediate/high-risk differentiated

Total thyroidectomy with therapeutic node dissection; radioiodine (1.1-3.7 GBq adjuvant; higher for known metastases) after recombinant TSH; TSH suppression.

NCCN · 2A
Radioactive iodine (I-131)Radioiodine therapy and whole-body iodine scanningHiLo
Radioiodine-refractory, progressive

Genotype first: selpercatinib (RET fusion), larotrectinib/entrectinib (NTRK), dabrafenib-trametinib (BRAF V600E); otherwise lenvatinib (or sorafenib); consider MAPK-inhibitor redifferentiation to restore iodine uptake.

NCCN · 1 (lenvatinib)ESMO-MCBS · 3
SELECTDECISIONSelpercatinibMAPK inhibitor redifferentiation → radioiodineRadioiodine-refractory (RAI-R) thyroid cancer
Medullary, localised

Total thyroidectomy with central neck dissection; prophylactic thyroidectomy in RET germline carriers by codon-based age; calcitonin surveillance.

NCCN · 2A
RETGermline (hereditary) testing
Medullary, advanced progressive RET-mutant

Selpercatinib first line (LIBRETTO-531); cabozantinib or vandetanib if RET-selective therapy unavailable or failed.

NCCN · 1 (preferred)ESMO-MCBS · 3
LIBRETTO-531SelpercatinibVandetanib
Anaplastic, BRAF V600E

Rapid BRAF testing; dabrafenib-trametinib (ROAR), often with pembrolizumab, then surgery and radiation if rendered resectable.

NCCN · 2A
ROAR (anaplastic thyroid cancer cohort)Dabrafenib + trametinibBRAF/MEK inhibition → surgery in anaplastic thyroid cancerBRAF/MEK plus PD-1 blockade as standard for BRAF-mutant anaplastic thyroid cancer
Anaplastic, BRAF wild-type

Multimodal chemoradiation (paclitaxel-based) if feasible; lenvatinib; immunotherapy for PD-L1-high or TMB-high; NTRK/RET/ALK agents if fusion-positive; early palliative care.

IMRT / IGRT (modern external beam)Pembrolizumab
Survivorship

Lifelong levothyroxine with risk-adapted TSH targets; calcium/PTH monitoring after surgery; salivary care after radioiodine; low-risk patients can be discharged to primary care.

TSH suppressionSupportive Care & Survivorship

Subtypes & biomarkers

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Subtypes
  • Papillary (~85%; BRAF V600E ~50%, RET/PTC fusions, RAS)
  • Follicular (RAS, PAX8-PPARG)
  • Oncocytic (Hürthle cell)
  • Poorly differentiated
  • Anaplastic (BRAF V600E ~40%, TP53, TERT)
  • Medullary (RET germline in MEN2 ~25%; somatic RET M918T)
  • Papillary microcarcinoma (≤1 cm; surveillance candidate)
  • Paediatric differentiated thyroid cancer (fusion-driven, often nodal, excellent survival)
Biomarkers clinicians test

Target prevalence in this cancer

Target / alterationPrevalenceSource
RET
~10-20% RET fusions in papillary
60-70%
Wikipedia
BRAF
Near-universal in some PTC variants
40-60%
cBioPortal (TCGA)
NTRK
2-3%
Wikipedia

How common each drug target or alteration is in this cancer. Population-level and approximate; see the target page for detail. Full matrix.

History

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  1. 1946Radioactive iodine: first theranostic
  2. 1946First patient treated with radioactive iodine for metastatic thyroid cancer

    Seidlin, Marinelli, and Oshry: the first theranostic.

    Radioactive iodine (I-131)Radioiodine therapy and whole-body iodine scanning
  3. 1985RET proto-oncogene identified; MEN2 germline RET mutations follow (1993)
    RET
  4. 2003BRAF V600E found in ~45% of papillary thyroid cancers
    BRAF
  5. 2009Bethesda System for thyroid cytology standardises nodule reporting
    Bethesda category (thyroid cytology)Thyroid nodule FNA, Bethesda cytology & molecular classifiers
  6. 2011Vandetanib: first drug for medullary thyroid cancer
    Vandetanib
  7. 2012HiLo and ESTIMABL1: low-dose radioiodine ablation is enough
    HiLo
  8. 2013Sorafenib approved for RAI-refractory disease (DECISION); selumetinib redifferentiation proof of concept
    DECISIONMAPK inhibitor redifferentiation → radioiodine
  9. 2015Lenvatinib approved (SELECT); ATA guidelines endorse active surveillance and less radioiodine
    SELECTActive surveillance of papillary microcarcinoma
  10. 2018Dabrafenib-trametinib approved for BRAF V600E anaplastic thyroid cancer (ROAR); larotrectinib tumour-agnostic
    ROAR (anaplastic thyroid cancer cohort)Dabrafenib + trametinibNTRK
  11. 2020Selpercatinib approved
    Selpercatinib
  12. 2020Selpercatinib and pralsetinib: RET-selective inhibitors approved
    SelpercatinibPralsetinibARROW (thyroid cohorts)
  13. 2022ESTIMABL2: no radioiodine for low-risk disease; ASTRA adjuvant redifferentiation negative
    ESTIMABL2ASTRA
  14. 2023LIBRETTO-531: selpercatinib beats cabozantinib/vandetanib in medullary cancer
    LIBRETTO-531
  15. 2025IoN confirms omission of radioiodine in low-risk disease (Lancet)
    IoN
  16. 2026Selpercatinib label update (July 2026)
    Selpercatinib

Pipeline

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ApprovedSmall-molecule kinase inhibitor (RET)
Selpercatinib · Retevmo
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)
BRAF/MEK plus PD-1 blockade as standard for BRAF-mutant anaplastic thyroid cancerBRAF/MEK inhibition → surgery in anaplastic thyroid cancerMAPK inhibitor redifferentiation → radioiodineUltrasound restraint and surveillance to reverse thyroid cancer overdiagnosisThyroid nodule FNA, Bethesda cytology & molecular classifiersActive surveillance of papillary microcarcinomaCirculating tumour HPV DNA (ctHPV-DNA)Targeted alpha therapyMRD / molecular residual disease testingDermoscopy, total-body photography & AI skin analysis

Open problems

  • Overdiagnosis of microcarcinoma.
  • Anaplastic thyroid cancer remains lethal.
  • Overdiagnosis: incidence has tripled with no change in mortality; most detected cancers would never have caused harm, yet surveillance uptake outside Japan and Korea remains low.
  • Anaplastic thyroid cancer without BRAF V600E (about 60%) still has a median survival of a few months.
  • Resistance to RET-selective inhibitors via solvent-front (G810) mutations has no approved next-generation drug.
  • Multikinase inhibitors for RAI-refractory disease cause hypertension, weight loss, and fatigue; most patients need dose reductions and quality of life suffers.
  • No validated way to predict which low-risk patients will be the rare ones to recur, so follow-up intensity is uniform.
  • Redifferentiation works in about half of refractory patients but predictors and optimal regimens are undefined.
  • Paediatric and radiation-induced thyroid cancers (Chernobyl, Fukushima cohorts) have distinct fusion-driven biology that is under-studied.
  • Hereditary MEN2 requires lifelong surveillance and prophylactic surgery in children; long-term outcomes of RET-selective therapy in this group are unknown.

Trials

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Recruiting now (live from ClinicalTrials.gov)

Recruiting trials near you · live from ClinicalTrials.gov
Thyroid cancer
condition: Thyroid cancer
Open on ClinicalTrials.gov →

Country and place are remembered in this browser only. A postcode is sent to OpenStreetMap's Nominatim service to find coordinates when you press the button; nothing else leaves your device.

Landmark trials in OnCo

ARROW (thyroid cohorts)ASTRADECISIONESTIMABL2HiLoIoNLIBRETTO-531ROAR (anaplastic thyroid cancer cohort)SELECT

Expert centres

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Where the expertise is

Centres linked to this cancer in OnCo

Seeking a second opinion: ask your oncologist for a referral to a high-volume centre; most accept records and pathology by mail or telehealth. In the US, use the NCI's Find a Cancer Center tool or the nonprofit Cancer Commons, which navigates options for advanced cancers at no cost.

Questions to ask

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Bring to your appointment

Questions to ask your oncologist about Thyroid cancer

Generated from this cancer's standard of care, biomarkers, and pipeline · 32 questions

Newly diagnosed

  1. What is my exact diagnosis, stage, and grade, and which tests established them?
    Why: Everything else follows from an accurate stage and subtype.
  2. Which biomarkers have been tested on my tumour (for example BRAF V600E, RET fusion/mutation, NTRK, RAS, TERT), and what were the results?
    Why: These results decide eligibility for targeted therapy, immunotherapy, and trials.
  3. Which subtype is my cancer, and does that change the recommended treatment?
    Why: Recognised subtypes for this cancer include Papillary, Follicular, Oncocytic.
  4. Is germline (inherited) genetic testing recommended for me or my family?
    Why: Inherited variants can change treatment and matter for relatives.

Differentiated

  1. For my situation (differentiated), which of the standard options do you recommend and why?
    Why: Guideline options include: Thyroidectomy ± radioactive iodine; TSH suppression.

Advanced/refractory

  1. For my situation (advanced/refractory), which of the standard options do you recommend and why?
    Why: Guideline options include: Lenvatinib; selpercatinib (RET); BRAF/MEK (anaplastic).
  2. Am I a candidate for Selpercatinib, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Nodule work-up

  1. For my situation (nodule work-up), which of the standard options do you recommend and why?
    Why: Guideline options include: Ultrasound with TI-RADS; FNA only for nodules meeting size/appearance thresholds; Bethesda reporting; molecular classifier (Afirma, ThyroSeq) for indeterminate results.

Papillary microcarcinoma (≤1 cm, no spread)

  1. For my situation (papillary microcarcinoma (≤1 cm, no spread)), which of the standard options do you recommend and why?
    Why: Guideline options include: Active surveillance or lobectomy; total thyroidectomy and radioiodine not indicated.

Low-risk differentiated (pT1-T2 N0)

  1. For my situation (low-risk differentiated (pt1-t2 n0)), which of the standard options do you recommend and why?
    Why: Guideline options include: Lobectomy or total thyroidectomy; no radioiodine ablation (ESTIMABL2, IoN); modest TSH suppression then normal-range TSH.
  2. How do the results of ESTIMABL2 and IoN apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Intermediate/high-risk differentiated

  1. For my situation (intermediate/high-risk differentiated), which of the standard options do you recommend and why?
    Why: Guideline options include: Total thyroidectomy with therapeutic node dissection; radioiodine (1.1-3.7 GBq adjuvant; higher for known metastases) after recombinant TSH; TSH suppression.
  2. Am I a candidate for Radioactive iodine (I-131), and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of HiLo apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Radioiodine-refractory, progressive

  1. For my situation (radioiodine-refractory, progressive), which of the standard options do you recommend and why?
    Why: Guideline options include: Genotype first: selpercatinib (RET fusion), larotrectinib/entrectinib (NTRK), dabrafenib-trametinib (BRAF V600E); otherwise lenvatinib (or sorafenib); consider MAPK-inhibitor redifferentiation to restore iodine uptake.
  2. Am I a candidate for Selpercatinib, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of SELECT and DECISION apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Medullary, localised

  1. For my situation (medullary, localised), which of the standard options do you recommend and why?
    Why: Guideline options include: Total thyroidectomy with central neck dissection; prophylactic thyroidectomy in RET germline carriers by codon-based age; calcitonin surveillance.

Medullary, advanced progressive RET-mutant

  1. For my situation (medullary, advanced progressive ret-mutant), which of the standard options do you recommend and why?
    Why: Guideline options include: Selpercatinib first line (LIBRETTO-531); cabozantinib or vandetanib if RET-selective therapy unavailable or failed.
  2. Am I a candidate for Selpercatinib, Vandetanib, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of LIBRETTO-531 apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Anaplastic, BRAF V600E

  1. For my situation (anaplastic, braf v600e), which of the standard options do you recommend and why?
    Why: Guideline options include: Rapid BRAF testing; dabrafenib-trametinib (ROAR), often with pembrolizumab, then surgery and radiation if rendered resectable.
  2. Am I a candidate for Dabrafenib + trametinib, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
  3. How do the results of ROAR (anaplastic thyroid cancer cohort) apply to someone like me?
    Why: Trial populations differ from individual patients; ask how closely you match.

Anaplastic, BRAF wild-type

  1. For my situation (anaplastic, braf wild-type), which of the standard options do you recommend and why?
    Why: Guideline options include: Multimodal chemoradiation (paclitaxel-based) if feasible; lenvatinib; immunotherapy for PD-L1-high or TMB-high; NTRK/RET/ALK agents if fusion-positive; early palliative care.
  2. Am I a candidate for Pembrolizumab, and what side effects should I expect?
    Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Survivorship

  1. For my situation (survivorship), which of the standard options do you recommend and why?
    Why: Guideline options include: Lifelong levothyroxine with risk-adapted TSH targets; calcium/PTH monitoring after surgery; salivary care after radioiodine; low-risk patients can be discharged to primary care.

Any stage

  1. Are there clinical trials I could join, for example of Selpercatinib, BRAF/MEK plus PD-1 blockade as standard for BRAF-mutant anaplastic thyroid cancer, BRAF/MEK inhibition → surgery in anaplastic thyroid cancer, MAPK inhibitor redifferentiation → radioiodine?
    Why: Trials are how the next standard of care is set; asking early keeps options open.
  2. Would a second opinion at a high-volume centre change anything, and can you help arrange it?
    Why: Rare or high-stakes decisions benefit from a centre that treats many similar patients.
  3. What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
    Why: Supportive care improves quality of life and helps patients complete treatment.
  4. I read that “Overdiagnosis of microcarcinoma”. How does that affect my plan?
    Why: Open problems are where trials and second opinions matter most.
  5. I read that “Anaplastic thyroid cancer remains lethal”. How does that affect my plan?
    Why: Open problems are where trials and second opinions matter most.

Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.

Everything relevant

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Direct links plus the targets, companies, and technologies of this cancer's products.

fronts

1
Supportive Care & Survivorship

technologies

15
Active surveillance of papillary microcarcinomaAnti-angiogenic therapyCirculating tumour HPV DNA (ctHPV-DNA)Comprehensive genomic profilingDermoscopy, total-body photography & AI skin analysisGermline (hereditary) testingImmune checkpoint inhibitorsIMRT / IGRT (modern external beam)MRD / molecular residual disease testingRadioiodine therapy and whole-body iodine scanningRadioligand therapy (beta emitters)Small-molecule kinase inhibitorsTargeted alpha therapyThyroid nodule FNA, Bethesda cytology & molecular classifiersUltrasound

targets

10
BRAFEGFRFGFR2KITMETNTRKPD-1RETSomatostatin receptor 2VEGF / VEGFR

drugs

10
ApprovedSmall-molecule multi-kinase inhibitor (MET, VEGFR2, AXL, RET)
Cabozantinib · Cabometyx
ApprovedSmall-molecule kinase inhibitors (BRAF + MEK)
Dabrafenib + trametinib · Tafinlar + Mekinist
Not mapped hereSmall-molecule pan-TRK inhibitor (first generation)
Larotrectinib · Vitrakvi
ApprovedSmall-molecule multi-kinase inhibitor (VEGFR, FGFR, PDGFR, RET, KIT)
Lenvatinib · Lenvima
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)
ApprovedSmall-molecule kinase inhibitor (RET)
Pralsetinib · Gavreto
ApprovedRadiopharmaceutical (beta/gamma emitter, natural uptake)
Radioactive iodine (I-131) · Sodium iodide I-131
ApprovedSmall-molecule kinase inhibitor (RET)
Selpercatinib · Retevmo
ApprovedSmall-molecule multi-kinase inhibitor (VEGFR, PDGFR, RAF)
Sorafenib · Nexavar
ApprovedSmall-molecule kinase inhibitor (RET, VEGFR, EGFR)
Vandetanib · Caprelsa

companies

10
AstraZenecaBayerEisaiEli Lilly (incl. Loxo)ExelixisIpsenMerck & Co. (MSD)NovartisSanofiVeracyte (Decipher)

institutions

9
Cancer Research UKFirst Affiliated Hospital of Sun Yat-sen UniversityGustave RoussyKing Faisal Specialist Hospital and Research CentreMD Anderson Cancer CenterMemorial Sloan Kettering Cancer CenterNational Cancer Center KoreaPeking Union Medical College HospitalTawam Hospital

pathways

2
RAS / RAF / MEK / ERK (MAPK)Receptor tyrosine kinase activation

terms

13
Active surveillance and observationBethesda category (thyroid cytology)BRAF V600E mutationLow-risk differentiated thyroid cancer (ATA risk)Obesity-related cancers (IARC list of 13)Radioiodine therapy (I-131)Radioiodine-refractory (RAI-R) thyroid cancerTERT promoter mutationTheranosticsThyroidectomyTSH suppressionTumour differentiation (well / moderately / poorly differentiated)Tumour markers (CEA, LDH, chromogranin, thyroglobulin)

trials

9
ARROW (thyroid cohorts)ASTRADECISIONESTIMABL2HiLoIoNLIBRETTO-531ROAR (anaplastic thyroid cancer cohort)SELECT

pairings

2
BRAF/MEK inhibition → surgery in anaplastic thyroid cancerMAPK inhibitor redifferentiation → radioiodine

roadmaps

1
Radiopharmaceutical roadmap: iodine → lutetium → actinium

ideas

11
A same-week expert second opinion for every rare cancer diagnosisActive surveillance as the default for tiny papillary thyroid cancersAn international body to rename indolent lesions so 'cancer' means somethingBRAF/MEK plus PD-1 blockade as standard for BRAF-mutant anaplastic thyroid cancerDevice-agnostic public trials of ablation technologies against surgeryModern autopsy studies to measure how much silent cancer people carryMolecular indolence classifiers bundled with every screening programmePayer-funded trials that omit surgery or radiotherapy in low-risk patientsRandomise inside the registry that already follows every patientStop biopsying small thyroid nodules and never screen the thyroidUltrasound restraint and surveillance to reverse thyroid cancer overdiagnosis

people

1
Alexander Drilon

bottlenecks

3
Overdiagnosis and false alarmsRare and paediatric cancers without marketsSurvivorship and late effects are neglected

key papers

1
IARC verdict: excess body fat causes 13 cancers

Key papers

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reviewNew England Journal of Medicine 2016changed practice
IARC verdict: excess body fat causes 13 cancers

Maintaining a healthy weight is now established cancer prevention for over a dozen cancer types. For clinicians and policymakers, obesity belongs alongside tobacco and alcohol in prevention strategy. Whether intentional weight loss in adulthood reverses risk is still being studied, including in trials of GLP-1 drugs.

Latest papers

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Literature trend1,861 papers in the last 12 months-14% vs prior 12How this is computed
Latest papers · live from Europe PMC
Open in Europe PMC

Query for this cancer: (TITLE:"Thyroid cancer" OR ABSTRACT:"Thyroid cancer") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Thyroid cancer, not a curated reading list.

Connected

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fronts

1
Supportive Care & Survivorship

technologies

12
Active surveillance of papillary microcarcinomaCirculating tumour HPV DNA (ctHPV-DNA)Dermoscopy, total-body photography & AI skin analysisGermline (hereditary) testingIMRT / IGRT (modern external beam)MRD / molecular residual disease testingRadioiodine therapy and whole-body iodine scanningRadioligand therapy (beta emitters)Small-molecule kinase inhibitorsTargeted alpha therapyThyroid nodule FNA, Bethesda cytology & molecular classifiersUltrasound

targets

5
BRAFNTRKPD-1RETVEGF / VEGFR

drugs

10
ApprovedSmall-molecule multi-kinase inhibitor (MET, VEGFR2, AXL, RET)
Cabozantinib · Cabometyx
ApprovedSmall-molecule kinase inhibitors (BRAF + MEK)
Dabrafenib + trametinib · Tafinlar + Mekinist
Not mapped hereSmall-molecule pan-TRK inhibitor (first generation)
Larotrectinib · Vitrakvi
ApprovedSmall-molecule multi-kinase inhibitor (VEGFR, FGFR, PDGFR, RET, KIT)
Lenvatinib · Lenvima
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)
ApprovedSmall-molecule kinase inhibitor (RET)
Pralsetinib · Gavreto
ApprovedRadiopharmaceutical (beta/gamma emitter, natural uptake)
Radioactive iodine (I-131) · Sodium iodide I-131
ApprovedSmall-molecule kinase inhibitor (RET)
Selpercatinib · Retevmo
ApprovedSmall-molecule multi-kinase inhibitor (VEGFR, PDGFR, RAF)
Sorafenib · Nexavar
ApprovedSmall-molecule kinase inhibitor (RET, VEGFR, EGFR)
Vandetanib · Caprelsa

companies

8
AstraZenecaBayerEisaiEli Lilly (incl. Loxo)ExelixisNovartisSanofiVeracyte (Decipher)

institutions

9
Cancer Research UKFirst Affiliated Hospital of Sun Yat-sen UniversityGustave RoussyKing Faisal Specialist Hospital and Research CentreMD Anderson Cancer CenterMemorial Sloan Kettering Cancer CenterNational Cancer Center KoreaPeking Union Medical College HospitalTawam Hospital

pathways

2
RAS / RAF / MEK / ERK (MAPK)Receptor tyrosine kinase activation

terms

13
Active surveillance and observationBethesda category (thyroid cytology)BRAF V600E mutationLow-risk differentiated thyroid cancer (ATA risk)Obesity-related cancers (IARC list of 13)Radioiodine therapy (I-131)Radioiodine-refractory (RAI-R) thyroid cancerTERT promoter mutationTheranosticsThyroidectomyTSH suppressionTumour differentiation (well / moderately / poorly differentiated)Tumour markers (CEA, LDH, chromogranin, thyroglobulin)

trials

9
ARROW (thyroid cohorts)ASTRADECISIONESTIMABL2HiLoIoNLIBRETTO-531ROAR (anaplastic thyroid cancer cohort)SELECT

pairings

2
BRAF/MEK inhibition → surgery in anaplastic thyroid cancerMAPK inhibitor redifferentiation → radioiodine

roadmaps

1
Radiopharmaceutical roadmap: iodine → lutetium → actinium

ideas

11
A same-week expert second opinion for every rare cancer diagnosisActive surveillance as the default for tiny papillary thyroid cancersAn international body to rename indolent lesions so 'cancer' means somethingBRAF/MEK plus PD-1 blockade as standard for BRAF-mutant anaplastic thyroid cancerDevice-agnostic public trials of ablation technologies against surgeryModern autopsy studies to measure how much silent cancer people carryMolecular indolence classifiers bundled with every screening programmePayer-funded trials that omit surgery or radiotherapy in low-risk patientsRandomise inside the registry that already follows every patientStop biopsying small thyroid nodules and never screen the thyroidUltrasound restraint and surveillance to reverse thyroid cancer overdiagnosis

people

1
Alexander Drilon

bottlenecks

3
Overdiagnosis and false alarmsRare and paediatric cancers without marketsSurvivorship and late effects are neglected

key papers

1
IARC verdict: excess body fat causes 13 cancers