Canadian consensus statement on the management of radioactive iodine-resistant differentiated thyroid cancer

Andrée Boucher; Shereen Ezzat; Sebastien Hotte; Irina Rachinsky; Murali Rajaraman; Dean Ruether; Sam M Wiseman; James Brierley; Cheryl Ho; Monika Krzyzanowska; Nathan Lamond; Marie-Hélène Massicotte; Shereen Joseph; Kassey Herscovitch; Lindsey Sikora; Eric Winquist

doi:10.1016/j.oraloncology.2021.105477

Canadian consensus statement on the management of radioactive iodine-resistant differentiated thyroid cancer

Oral Oncol. 2021 Oct:121:105477. doi: 10.1016/j.oraloncology.2021.105477. Epub 2021 Aug 10.

Authors

Andrée Boucher¹, Shereen Ezzat², Sebastien Hotte³, Irina Rachinsky⁴, Murali Rajaraman⁵, Dean Ruether⁶, Sam M Wiseman⁷, James Brierley⁸, Cheryl Ho⁹, Monika Krzyzanowska², Nathan Lamond¹⁰, Marie-Hélène Massicotte¹¹, Shereen Joseph¹², Kassey Herscovitch¹², Lindsey Sikora¹³, Eric Winquist¹⁴

Affiliations

¹ Department of Endocrinology, University of Montreal, Montreal, Quebec, Canada.
² Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
³ Department of Oncology, McMaster University, Hamilton, Ontario, Canada.
⁴ Department of Medical Imaging, Division of Nuclear Medicine, University of Western Ontario, London, Ontario, Canada.
⁵ Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada.
⁶ Department of Oncology, University of Calgary, Calgary, Alberta, Canada.
⁷ Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
⁸ Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
⁹ Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
¹⁰ Division of Medical Oncology, Dalhousie University, Halifax, Nova Scotia, Canada.
¹¹ Department of Medicine, Division of Endocrinology, University of Sherbrooke, Sherbrooke, Quebec, Canada.
¹² Kataka Medical Communication, 4035 St. Ambroise, Suite 300, Montreal, Quebec, Canada.
¹³ Health Sciences Library, University of Ottawa, Ottawa, Canada.
¹⁴ Departments of Oncology and Otolaryngology/Head & Neck Surgery, University of Western Ontario, London, Ontario, Canada. Electronic address: eric.winquist@lhsc.on.ca.

PMID: 34388408
DOI: 10.1016/j.oraloncology.2021.105477

Abstract

Radioactive iodine-resistant differentiated thyroid cancer (RAIRTC) is an aggressive form of thyroid cancer that is uncommon and heterogeneous in its clinical behavior. With the emergence of more effective systemic therapy, the need for guidance in decision-making was recognized and a consensus committee of national experts was assembled. The consensus committee consisted of 13 clinicians involved in treating RAIRTC from across Canada and included endocrinologists, nuclear medicine physicians, surgeons, and radiation and medical oncologists. Domains of interest were identified by consensus, and evidence gathered using systematic reviews. Consensus recommendations for the diagnosis and management of RAIRTC were developed. It was recognized that the rarity of RAIRTC in practice and heterogeneous patterns of thyroid cancer care could limit access to effective therapy for some RAIRTC patients. This document offers guidance to manage RAIRTC patients in a multidisciplinary manner.

Keywords: Differentiated thyroid cancer; Head and Neck Neoplasms; Iodine Radioisotopes; Lenvatinib; Protein Kinase Inhibitors; Radioactive iodine; Refractory; Resistant; Sorafenib; Thyroid Neoplasms.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Antineoplastic Agents* / therapeutic use
Canada
Consensus
Humans
Iodine Radioisotopes* / therapeutic use
Radiation Tolerance*
Radiopharmaceuticals / therapeutic use
Thyroid Neoplasms* / radiotherapy

Substances

Antineoplastic Agents
Iodine Radioisotopes
Radiopharmaceuticals