Medical Treatment Horizons for Metastatic Differentiated and Medullary Thyroid Cancer

Abstract Metastatic differentiated thyroid cancer (DTC) and medullary thyroid cancer (MTC) are rare tumors with limited treatment options and an overall poor response to cytotoxic chemotherapy. Oral small molecule inhibitors such as sorafenib, lenvatinib, vandetanib, and cabozantinib have become new standard therapies in advanced thyroid cancer. These drugs target different molecular pathways and have shown to provide clinical benefit, but off-target side effects can take a toll on the patient’s quality of life (QoL). Initiation of systemic treatment warrants a discussion of benefits against the potential risks in therapeutic decision making. Other more selective drugs are currently being studied to expand the arsenal of treatment options for advanced thyroid cancer that carry a less toxic side effects profile and better tolerability.