title: Thyroid Gland Malignancies.
abstract: Surgery remains the most important effective treatment for differentiated (DTC) and medullary thyroid cancer (MTC). Radioactive iodine (RAI) is another important treatment but is reserved only for DTC whose disease captures RAI. Once patients fail primary therapy, observation is often recommended, as most DTC and MTC patients will have indolent disease. However, in a fraction of patients, systemic therapy must be considered. In recent decades 4 systemic therapies have been approved by the United States FDA for DTC and MTC. Sorafenib and lenvatinib are approved for DTC and vandetanib and cabozantinib for MTC. Anaplastic thyroid cancer (ATC) is a rare and rapidly progressive form of thyroid cancer with a very high mortality rate. Treatment of ATC remains a challenge. Most patients are not surgical candidates at diagnosis due to advanced disease. External beam radiation and radiosensitizing radiation are the mainstay of therapy at this time. However, exciting new drugs and approaches to therapy are on the horizon but it will take a concerted, worldwide effort to complete clinical trials in order to find effective therapies that will improve the overall survival for this devastating disease.
authors.affiliation: Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1461, Houston, TX 77030, USA. Electronic address: mcabani@mdanderson.org.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Cabanillas
authors.affiliation: Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1461, Houston, TX 77030, USA.
authors.forename: Ramona
authors.initials: R
authors.lastname: Dadu
authors.affiliation: Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1461, Houston, TX 77030, USA.
authors.forename: Mimi I
authors.initials: MI
authors.lastname: Hu
authors.affiliation: Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 432, Houston, TX 77030, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Lu
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 97, Houston, TX 77030, USA.
authors.forename: Gary Brandon
authors.initials: GB
authors.lastname: Gunn
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX 77030, USA.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Grubbs
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
authors.forename: Stephen Y
authors.initials: SY
authors.lastname: Lai
authors.affiliation: Pathology Head and Neck Section, Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 85, Houston, TX 77030, USA.
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Williams
mesh_terms: D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy / Q000379:methods; D019468:Disease Management; D006801:Humans; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Anaplastic; Cabozantinib; Differentiated; Lenvatinib; Medullary; Sorafenib; Thyroid cancer; Vandetanib