Optimizing Therapy for Patients Radioactive Iodine Refractory Differentiated Thyroid Cancer (RAI-R-DTC)

Medical experts provide an overview of differentiated thyroid cancer, highlighting key epidemiological trends, and discuss the impact of thyroid cancer in women.

Marcia Brose, MD, delivers a comprehensive overview of differentiated thyroid cancer, detailing the incidence rates, histological features, genetic profiles, and phenotypic characteristics associated with this malignancy, providing valuable insights into the complex nature of the disease.

Francis Worden, MD, discusses the prognosis for patients with differentiated thyroid cancer, distinguishing between those who can be put on close surveillance and those who require immediate treatment, while the panel weighs in on best practices for predicting and anticipating disease-related obstructions prior to the onset of symptoms.

The panel explores potential reasons for the higher incidence of thyroid cancer diagnoses in women compared to men, while also discussing diagnosis in the pediatric population and examining the influence of environmental and genetic factors on detection bias.

Daniel Bowles, MD, explores the role of molecular testing in driving treatment decisions and its application in the initial diagnosis stage, while also discussing driver mutations, primary surgeries, and the importance of high-quality DNA and RNA, highlighting the 2-year window for durable RNA sequencing.

Francis Worden, MD, and Hyunseok Kang, MD, express caution regarding the use of liquid biopsies due to discordant findings and the potential lack of tumor shedding compared to other solid tumors, while also warning about the misinterpretation of Clonal hematopoiesis of indeterminate potential mutations.

Medical professionals discuss the role of thyroidectomy and nodal disease in leading to surgery, providing an overview of the various surgical treatment options available for differentiated thyroid cancer.

The panel discusses the importance of thyroid hormone replacement and TSH suppression, highlighting the role of endocrinologists in managing the risk of cardiovascular disease. Dr. Brose also addresses the potential long-term risks associated with radioactive iodine treatment in the post-surgery setting, including cytopenia, salivary gland issues, and excessive tearing of the eyes.

Daniel Bowles, MD, leads a discussion on radioactive iodine (RAI) refractory disease, exploring the incidence and resistance levels, and provides recommendations for identifying patient populations who are ineligible for radioiodine treatment.

Francis Worden, MD, analyzes the outcomes of the SELECT and DECISION Trials, focusing on progression-free survival, and provides recommendations for their application in clinical practice.

Hyunseok Kang, MD, discusses the importance of balancing toxicities and other factors when initiating first-line treatments for patients with refractory differentiated thyroid cancer (DTC), while emphasizing the need to set clear goals and communicate potential adverse reactions before allowing patients to make informed decisions.

Medical professionals discuss the recently published real-world evidence presented at the American Thyroid Association 2023 Conference.