| Systemic therapy for differentiated thyroid cancer with distant metastasis |
Eun Kyung Lee 
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Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, Goyang, Korea |
| 원격전이를 동반한 갑상선분화암의 전신항암요법 |
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이은경
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국립암센터 갑상선암센터 내분비내과 |
Correspondence:
Eun Kyung Lee,
Email: eklee@ncc.re.kr
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Received: 26 May 2024 • Accepted: 15 June 2024 |
| Abstract |
Background: Thyroid cancer is a slow-growing tumor with excellent oncological outcomes. However, few patients with unexpectedly severe outcomes are usually ignored.
Current Concepts: Radioactive iodine therapy is the mainstay treatment for differentiated thyroid cancer with distant metastasis. The refractoriness to radioactive iodine therapy has been overcome by the emergence of targeted agents. First, multikinase inhibitors (sorafenib and lenvatinib) targeting the growth factor pathway were developed and approved as anticancer agents for patients with advanced differentiated thyroid cancer, regardless of their genetic features. With progress in sequencing techniques, the genetic backgrounds of tumors have unveiled new targets, including rearrangements during transformation and tropomyosin receptor kinase. Special attention should be paid to the national health insurance coverage of systemic therapeutics and genetic studies.
Discussion and Conclusion: New drugs were introduced to treat previously untreatable advanced thyroid cancers. However, the cost of these drugs has increased with new developments, and only first-line drugs for thyroid cancer are still covered by insurance. These medical advances will remain an illusion for clinics and patients if improvements in healthcare policies do not accompany them. |
| Key Words:
Thyroid neoplasm, Drug therapy, Molecular targeted therapy |
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