Molecular-Driven Therapy in Advanced Thyroid Cancer

Opinion statement

With a growing understanding of the biologic drivers of different thyroid cancers, there is an ongoing revolution in the treatment of aggressive and advanced disease variants. This includes matching patients with specific point mutations or gene fusions to targeted therapies (e.g., selective RET inhibitors), delineating patients who are likely to respond to immune checkpoint inhibition (i.e., PD-L1-positive tumors) and even priming responses to traditional therapies such as radioactive iodine (via concomitant MAPK pathway inhibition). There is also a growing role for genomics in the prognostication of thyroid tumors to aid the adjudication of appropriate treatments. Taking stock of the current state of the field, recent successes should be celebrated, but there still remains a long road ahead to improve outcomes for patients, particularly for radioactive-iodine refractory differentiated thyroid cancer and anaplastic thyroid cancer. In this review, we summarize findings from recent clinical trials and highlight promising preclinical data supporting molecular-driven therapy in advanced thyroid cancer. Ultimately, enrollment in clinical trials remains paramount to the advancement of thyroid cancer care.

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Correspondence to Ashish V. Chintakuntlawar MBBS, PhD.

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Kevin C. Miller declares that he has no conflict of interest. Ashish V. Chintakuntlawar has received clinical trial funding (paid to his institution) from Merck, AstraZeneca/MedImmune, Kura Oncology, Inovio Pharmaceuticals, and Eisai, and has served on advisory boards for Kura Oncology and HRA Pharma (both institutional).

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Miller, K.C., Chintakuntlawar, A.V. Molecular-Driven Therapy in Advanced Thyroid Cancer. Curr. Treat. Options in Oncol. 22, 24 (2021). https://doi.org/10.1007/s11864-021-00822-7

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Keywords

  • Thyroid cancer
  • Targeted therapy
  • Genomics
  • Immunotherapy