Molecular-Driven Therapy in Advanced Thyroid Cancer

• Published in: Current treatment options in oncology Vol. 22; no. 3; p. 24
• Main Authors: Miller, Kevin C., Chintakuntlawar, Ashish V.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-03-2021; Springer Nature B.V
• Subjects: Biomarkers, Tumor; Cancer therapies; Clinical trials; Combined Modality Therapy; Disease Management; Disease Susceptibility; Genomics - methods; Head and Neck Cancer (JL Geiger; Humans; Immune checkpoint inhibitors; Immunotherapy; Iodine; MAP kinase; Medicine; Medicine & Public Health; Molecular Targeted Therapy - adverse effects; Molecular Targeted Therapy - methods; Neoplasm Grading; Neoplasm Staging; Oncology; Patients; PD-L1 protein; Prognosis; Section Editor; Thyroid cancer; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - etiology; Thyroid Neoplasms - mortality; Thyroid Neoplasms - therapy; Topical Collection on Head and Neck Cancer; Treatment Outcome; Tumors; Thyroid cancer; Targeted therapy; Genomics; Immunotherapy
• ISSN: 1527-2729; 1534-6277; 1534-5277
• DOI: 10.1007/s11864-021-00822-7

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.