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REVIEW article

Front. Oncol.
Sec. Head and Neck Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1437360

Multidisciplinary Canadian Consensus on the Multimodal Management of High-risk and Radioactive Iodine-refractory Thyroid Carcinoma

Provisionally accepted
Shereen Ezzat Shereen Ezzat 1*Eric Winquist Eric Winquist 2Murali Rajaraman Murali Rajaraman 3Jesse D. Pasternak Jesse D. Pasternak 4Ozgur Mete Ozgur Mete 5
  • 1 Princess Margaret Cancer Centre, University Health Network (UHN), Toronto, Canada
  • 2 Verspeeten Family Cancer Centre at London Health Sciences Centre, London, Canada
  • 3 Dalhousie University, Halifax, Nova Scotia, Canada
  • 4 Department of Surgery, UHN - Toronto Western Hospital, Toronto, Canada
  • 5 Lab Medicine Program, UHN - Toronto General Hospital, Toronto, Canada

The final, formatted version of the article will be published soon.

    Most follicular cell-derived differentiated thyroid carcinomas are regarded as low-risk neoplasms prompting conservative therapeutic management. Here, we provide consensus recommendations reached by a multidisciplinary group of endocrinologists, medical oncologists, pathologists, radiation oncology specialists, a surgeon and a medication reimbursement specialist, addressing more challenging forms of this malignancy, focused on radioactive iodine (RAI)-resistant or -refractory differentiated thyroid carcinoma (RAIRTC). In this document we highlight clinical, radiographic, and molecular features providing the basis for these management plans. We distinguish differentiated thyroid cancers associated with more aggressive behavior from thyroid cancers manifesting as poorly differentiated and/or anaplastic carcinomas. Treatment algorithms based on risk-benefit assessments of different multimodal therapy approaches are also discussed. Given the scarcity of data supporting management of this rare yet aggressive disease entity, these consensus recommendations provide much needed guidance for multidisciplinary teams to optimally manage RAIRTC.

    Keywords: thyroid cancer, targeted therapy, Molecular diagnosis, radioiodine-refractory differentiated thyroid cancer, multidisciplinary 1

    Received: 23 May 2024; Accepted: 10 Sep 2024.

    Copyright: © 2024 Ezzat, Winquist, Rajaraman, Pasternak and Mete. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Shereen Ezzat, Princess Margaret Cancer Centre, University Health Network (UHN), Toronto, Canada

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.