Published online Jan 24, 2022. doi: 10.5306/wjco.v13.i1.9
Peer-review started: April 12, 2021
First decision: August 18, 2021
Revised: August 31, 2021
Accepted: December 31, 2021
Article in press: December 31, 2021
Published online: January 24, 2022
The cumulative evidence over the past decades has shown that the incidence of differentiated thyroid carcinoma (DTC) has exponentially increased. Approximately 10% of patients with DTC exhibit recurrent or metastatic disease, and about two-thirds of the latter will be defined as refractory to radioactive iodine (RAIR) treatment. Since this condition implies 10-year survival rates less than 10% after detection, using available treatments, such as systemic and targeted therapies, have become increasingly relevant. The initiation of these treatments aims to reach stabilization, tumor volume reduction, and/or symptom impro
Core Tip: The incidence of differentiated thyroid carcinoma has increased due to the rising detection of low-risk small carcinomas. Nevertheless, approximately 10% of patients exhibit advanced disease and two-thirds of the latter will be defined as radioactive iodine (RAI) refractory. After detection, 10-year survival rates are less than 10%, therefore the role of systemic and targeted therapy in these patients has become increasingly relevant in recent years. This review article aims to provide a summary of the current therapeutic strategies in iodine-refractory thyroid cancer, including approved target therapies as well as those for off-label use, RAI resensitization agents, and immunotherapy.