An overview of the standard of care treatment for patients with advanced radioiodine-refractory differentiated thyroid cancer.
Case: A 64-Year-Old Woman with DTC
Initial presentation
Clinical workup and initial treatment
Subsequent treatment and follow-up
This is a video synopsis/summary of a Case-Based Peer Perspective featuring Lori Wirth, MD.
Wirth discusses the National Comprehensive Cancer Network guidelines for patients with progressive radioactive iodine (RAI)–refractory differentiated thyroid cancer (DTC). The guidelines recommend molecular diagnostics whenever possible before initiating therapy due to the availability of gene-specific first-line treatment options, such as larotrectinib or entrectinib for NTRK fusion–positive patients and selpercatinib or pralsetinib for RET fusion–positive disease. Lenvatinib has a preferred category 1 recommendation for progressive RAI-refractory DTC without oncogenic gene fusions, while sorafenib also has a category 1 recommendation.
One challenge in initiating treatment is determining the appropriate timing. Asymptomatic patients with a low disease burden and slow growth may not require immediate therapy, and ongoing disease monitoring and thyroid-stimulating hormone suppression may be the most appropriate approach. However, patients with rapidly progressive RAI-refractory DTC or those likely to develop disease progression symptoms should initiate treatment. Subset analyses from the SELECT trial suggest that symptomatic patients do not respond to treatment, emphasizing the importance of not waiting until symptoms develop before starting therapy.
Video synopsis is AI-generated and reviewed by Targeted Oncology® editorial staff.
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May 15th 2023In season 4, episode 6 of Targeted Talks, Warren Swegal, MD, takes a multidisciplinary look at the RAI-refractory differentiated thyroid cancer treatment landscape, including the research behind 2 promising systemic therapy options.
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Wirth Explores Challenges of Therapy Selection for RAI-Refractory Differentiated Thyroid Cancer
June 28th 2024During a Case-Based Roundtable® event, Lori J. Wirth, MD, discussed with participants how they approach use of lenvatinib and other therapy for patients with radioactive iodine–refractory differentiated thyroid cancer.
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SELECT Trial Establishes Lenvatinib’s Role in RAI-Refractory DTC
May 2nd 2024In an interview with Targeted Oncology, Lori J. Wirth, MD, delved into how the data from SELECT signals lenvatinib effectiveness as a frontline therapy for patients with RAI-refractory differentiated thyroid cancer.
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