Abstract:
Background. Although thyroid carcinoma is a disease with a good prognosis, forms
refractory to radioactive iodine and poorly differentiated forms present challenges for
clinicians. Studies indicate that these patients have median 5-year survival rates of 60% and
10% for metastatic forms.
Objective(s). This review focuses on current treatment options in advanced thyroid cancer,
summarizing advances in targeted therapies such as tyrosine kinase inhibitors and
monoclonal antibodies.
Materials and methods. A narrative review of the recent literature (2018-2024) on
systemic treatment options for advanced thyroid cancer, including phase II and III clinical
trials, international guidelines, and research, was performed, with the main sources being
PubMed and UpToDate on targeted therapies, MABs, and specific molecular inhibitors.
Results. Multi-targeted tyrosine kinase inhibitors, such as lenvatinib and sorafenib,
increased progression-free survival (PFS) by an average of 18.3 months in 64.8% of patients
and were approved by the FDA. Significant responses were also seen with RET inhibitors,
BRAF/MEK, larotrectinib, according to the tumor molecular profile, showing the
Objective(s). response of 79% with a PFS of 20.1 months. The problem with these is the
limited indications for their use due to the need for in-depth study of genetic modulations in
tumor tissue and positive results. s only in specific subgroups. Other preparations with
promising results are in pre-clinical stages.
Conclusion(s). Targeted therapies have revolutionized the management of patients with
ACTs, leading to improved PFS, however, questions remain about the optimal time to initiate
systemic treatment, the limitations of molecular analysis, and the high specificity of some
drugs, but the outlook is promising.
