title: Radioiodine therapy for thyroid cancer in the era of risk stratification and alternative targeted therapies.
abstract: Differentiated thyroid cancers are typically iodine-avid and can be effectively treated with radioiodine. In most patients, radioiodine treatment is done for ablation of residual tissue, and in these cases the focus should be on using the minimum effective dose. Adjuvant therapy can be done to reduce the risk of recurrence, but optimal patient selection and dose are unclear. Patients with advanced disease benefit most from treatment with the maximum-tolerated dose. Recent research has focused on better patient selection and reduced radioiodine doses for remnant ablation. There are emerging targeted therapeutic approaches in patients who are appropriately shown to have iodine-refractory disease, with 1 drug approved by the Food and Drug Administration. Numerous trials are ongoing to assess targeted therapeutics alone or in combination with radioiodine.
authors.affiliation: Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and daniel.pryma@uphs.upenn.edu.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Pryma
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Mandel
mesh_terms: D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D018579:Patient Selection; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D013964:Thyroid Neoplasms / Q000532:radiotherapy*
chemical_list: D007457:Iodine Radioisotopes; D047428:Protein Kinase Inhibitors
keywords: iodine-refractory disease; multitargeted kinases; radioiodine therapy; thyroid cancer