The treatment of radioiodine-refractory differentiated thyroid carcinoma (rrDTC) and medullary thyroid carcinoma (MTC) remains challenging. Based on phase III clinical studies, four multi-kinase inhibitors (MKI) are approved for the treatment of progressive thyroid cancer in Germany. The indications for starting systemic treatment remain a challenge as the diseases can be stable and asymptomatic over long periods of time. In contrast, MKI treatment, which slows the disease progression but is not curative, is often associated with side effects that can impair quality of life. For this reason, an aim is to develop more specific treatments with low off-target effects. In this context selective RET kinase inhibitors represent a promising new approach, which is currently tested intensively in clinical trials, e.g. for advanced symptomatic MTC.
Keywords: Advanced differentiated thyroid carcinoma; Medullary thyroid cancer; Multi-kinase inhibitors; Radioiodine-refractory thyroid carcinoma; Selective treatment.