Challenges With Treating Asymptomatic RAI-Refractory Differentiated Thyroid Cancer

February 4, 2021

Marcia Brose, MD, PhD discusses the key unanswered questions oncologists have for treating patients with asymptomatic radioactive iodine-refractory differentiated thyroid cancer.

Marcia Brose, MD, PhD a medical oncologist at Penn Medicine, discusses the key unanswered questions oncologists have for treating patients with asymptomatic radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC).

In the field, there is a plethora of data around sorafenib (Nexavar) and lenvatinib (Lenvima), which are based on large phase 2 clinical trials performed for patients with RAI-refractory DTC that is growing. The population is broad, and it is difficult to understand which patients are actively progressing and which are more indolently progressing, says Brose. Determining when to start therapy for these patients is the key challenge, she adds.

A potential strategy for answering the question, Brose states, is to start therapy immediately for some patients and wait for others. Then, Brose explains, oncologists will be able to determine whether there was a difference in patients’ performance on the drug based on the time to initiation of treatment.