title: Consensus on the management of advanced radioactive iodine-refractory differentiated thyroid cancer on behalf of the Spanish Society of Endocrinology Thyroid Cancer Working Group (GTSEEN) and Spanish Rare Cancer Working Group (GETHI).
abstract: Thyroid cancer is the single most prevalent endocrine malignancy; differentiated thyroid cancer (DTC) accounts for more than 90 % of all malignancies and its incidence has been rising steadily. For more patients, surgical treatment, radioactive iodine (RAI) ablation, and thyroid-stimulating hormone (TSH) suppressive therapy achieve an overall survival (OS) rate of 97.7 % at 5 years. Nevertheless, locoregional recurrence occurs in up to 20 % and distant metastases in approximately 10 % at 10 years. Two-thirds of these patients will never be cured with radioactive iodine therapy and will become RAI-refractory, with a 3-year OS rate of less than 50 %. Over the last decade, substantial progress has been made in the management of RAI-refractory DTC. Given the controversy in some areas, the Spanish Task Force for Thyroid Cancer on behalf of Spanish Society of Endocrinology Thyroid Cancer Working Group (GTSEEN) and the Spanish Rare Cancer Working Group (GETHI) have created a national joint task force to reach a consensus addressing the most challenging aspects of management in these patients. In this way, multidisciplinary management should be mandatory and nuclear medicine targeted therapy, novel molecular targeted agents, and combinations are currently changing the natural history of RAI-refractory DTC.
authors.affiliation: Medical Oncology Department, Hospital Universitario Vall d'Hebron, Vall d'Hebron Institute of Oncology, Barcelona, Spain. jacapdevila@vhebron.net.
authors.forename: J
authors.identifier: http://orcid.org/0000-0003-4592-3813
authors.initials: J
authors.lastname: Capdevila
authors.affiliation: Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: J C
authors.initials: JC
authors.lastname: Galofré
authors.affiliation: Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Grande
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Zafón Llopis
authors.affiliation: Medical Oncology Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Ramón Y Cajal Asensio
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario Virgen del Rocío, Seville, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Navarro González
authors.affiliation: Medical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Jiménez-Fonseca
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario de Cruces, Vizcaya, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Santamaría Sandi
authors.affiliation: CIBERDEM Service of Endocrinology and Nutrition, Hospital Universitario de Bellvitge, Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Gómez Sáez
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario de Móstoles, Madrid, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Riesco Eizaguirre
mesh_terms: D002454:Cell Differentiation / Q000187:drug effects* / Q000528:radiation effects; D019468:Disease Management; D006801:Humans; D007457:Iodine Radioisotopes; D058990:Molecular Targeted Therapy; D017410:Practice Guidelines as Topic / Q000592:standards*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011836:Radiation Tolerance / Q000187:drug effects*; D013964:Thyroid Neoplasms / Q000188:drug therapy*
chemical_list: D007457:Iodine Radioisotopes; D047428:Protein Kinase Inhibitors
keywords: Differentiated thyroid cancer; Lenvatinib; Radioactive iodine-refractory thyroid cancer; Review; Sorafenib; Targeted therapy; Thyroid cancer