{"id":1405,"date":"2021-02-26T12:52:08","date_gmt":"2021-02-26T17:52:08","guid":{"rendered":"http:\/\/tiro.flywheelsites.com\/?page_id=1405"},"modified":"2023-07-24T11:43:04","modified_gmt":"2023-07-24T16:43:04","slug":"systemic-therapy","status":"publish","type":"page","link":"https:\/\/tiro.expert\/es\/recommendations\/dtc\/systemic-therapy\/","title":{"rendered":"Terapia sist\u00e9mica"},"content":{"rendered":"\t<style media=\"screen\">\n\t:root { --row-count: 4; }\n\t<\/style>\n<div class=\"clinical-outline-wrap open\">\n\t<div class=\"outline-header\">\n\t\t<p><strong>Systemic Therapy<\/strong><\/p>\t\t<p>Clinical Outline<\/p>\n\t<\/div>\n\n\t<div id=\"toc\">\n\t\t<div class=\"aod-opener opened\"><\/div>\n\t\t<div class=\"toc-content\"><\/div>\n\t<\/div>\n\n\t<div id=\"edu\" class=\"wp-block-group__inner-container legend\">\n\t\t<div class=\"aod-opener\"><\/div>\n\n\t\t<div class=\"table-wrap aod-content\">\n\t\t\t<div class=\"table-grid\">\n\n\t\t\t\t<div class=\"table-header table-row\">\n\t\t\t\t\t<div class=\"fixed-col\">Educational Clips from TIROxMDS<\/div>\n\n\t\t\t\t\t<div><i class=\"fad fa-chalkboard-teacher fa-fw fa-lg\" title=\"Primers in Thyroidology\"><\/i><\/div>\n\t\t\t\t\t<div><i class=\"fad fa-presentation fa-fw fa-lg\" title=\"Journal Club Presentation\"><\/i><\/div>\n\t\t\t\t\t<div><i class=\"fad fa-comments fa-fw fa-lg\" title=\"Case-based Discussion (inc. roundtables)\"><\/i><\/div>\n\t\t\t\t\t<div><i class=\"fad fa-podium fa-fw fa-lg\" title=\"Grand Rounds Lectureship\"><\/i><\/div>\n\n\t\t\t\t<\/div>\n\n\t\t\t\t\n\t\t\t\t<div class=\"table-row\">\n\n\t\t\t\t\t<div class=\"fixed-col\"><a href=\"#1-rai-refractory-metastatic-disease\">1. RAI Refractory Metastatic Disease<\/a><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"check\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"check\"><\/i><\/div>\n\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t<div class=\"table-row\">\n\n\t\t\t\t\t<div class=\"fixed-col lvl-2\"><a href=\"#edu-1a\">A. Role of Resensitization for RAIR Disease<\/a><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"check\"><\/i><\/div>\n\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t<div class=\"table-row\">\n\n\t\t\t\t\t<div class=\"fixed-col lvl-2\"><a href=\"#edu-1b\">B. Multikinase Inhibitors<\/a><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"check\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t<div class=\"table-row\">\n\n\t\t\t\t\t<div class=\"fixed-col\"><a href=\"#2-consideration-for-patients-who-fail-therapy\">2. Consideration for Patients Who Fail Therapy<\/a><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t<div class=\"table-row\">\n\n\t\t\t\t\t<div class=\"fixed-col\"><a href=\"#3-neoadjuvant-therapy-decision-making-about-surgery-with-systemic-therapy\">3. Neoadjuvant Therapy &amp; Decision-making About Surgery with Systemic Therapy<\/a><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t<div class=\"table-row\">\n\n\t\t\t\t\t<div class=\"fixed-col\"><a href=\"#4-the-role-of-external-beam-radiotherapy-ebrt\">4. The Role of External Beam Radiotherapy (EBRT)<\/a><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"\"><\/i><\/div>\n\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t<div class=\"table-row\">\n\n\t\t\t\t\t<div class=\"fixed-col\"><a href=\"#5-cytotoxic-chemotherapy\">5. Cytotoxic Chemotherapy<\/a><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t<div class=\"table-row\">\n\n\t\t\t\t\t<div class=\"fixed-col\"><a href=\"#6-bisphosphonate-rank-ligand-inhibitor\">6. Bisphosphonate\/Rank Ligand Inhibitor<\/a><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t<div class=\"table-row\">\n\n\t\t\t\t\t<div class=\"fixed-col\"><a href=\"#edu-7\">7. Targeted Therapies Against Specific Tumor Alterations<\/a><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"check\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t<div class=\"table-row\">\n\n\t\t\t\t\t<div class=\"fixed-col\"><a href=\"#8-indications-for-somatic-tumor-genetic-testing-dna-rna\">8. Indications for Somatic Tumor Genetic Testing (DNA\/RNA)<\/a><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"\"><\/i><\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t<div><i class=\"null\"><\/i><\/div>\n\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t<div id=\"key\" class=\"legend\">\n\t\t\t\t<div>\n\t\t\t\t\t<div>\n\t\t\t\t\t\t<div><i class=\"fad fa-chalkboard-teacher fa-fw fa-lg\"><\/i><\/div>\n\t\t\t\t\t\t<p> = Primers in Thyroidology<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div>\n\t\t\t\t\t\t<div><i class=\"fad fa-presentation fa-fw fa-lg\"><\/i><\/div>\n\t\t\t\t\t\t<p> = Journal Club Presentation<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div>\n\t\t\t\t\t\t<div><i class=\"fad fa-comments fa-fw fa-lg\"><\/i><\/div>\n\t\t\t\t\t\t<p> = Case-based Discussion (inc. roundtables)<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<div>\n\t\t\t\t\t\t<div><i class=\"fad fa-podium fa-fw fa-lg\"><\/i><\/div>\n\t\t\t\t\t\t<p> = Grand Rounds Lectureship<\/p>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t<\/div>\n\t<\/div>\n\n\t<div class='outline-tab closer'><i class='fas fa-times'><\/i><\/div>\n\n\t<div id=\"areas-discord\" class=\"legend cloak\">\n\t\t<div class=\"aod-opener\"><\/div>\n\t\t<div class=\"aod-content\"><\/div>\n\t<\/div>\n\t<div class=\"logo-wrap\">\n\t\t<div class=\"widget widget_media_image\"><div class=\"widget-content\"><a href=\"\/\"><img loading=\"lazy\" decoding=\"async\" width=\"250\" height=\"250\" src=\"https:\/\/tiro.expert\/wp-content\/uploads\/2021\/01\/TIRO-monogram-logo@3x-e1610777576269.png\" class=\"image wp-image-1039  attachment-full size-full\" alt=\"TIRO Thyroid International Recommendations Online monogram logo\" style=\"max-width: 100%; height: auto;\" srcset=\"https:\/\/tiro.expert\/wp-content\/uploads\/2021\/01\/TIRO-monogram-logo@3x-e1610777576269.png 250w, https:\/\/tiro.expert\/wp-content\/uploads\/2021\/01\/TIRO-monogram-logo@3x-e1610777576269-150x150.png 150w\" sizes=\"auto, (max-width: 250px) 100vw, 250px\" \/><\/a><\/div><\/div>\t<\/div>\n\t<div class=\"site-nav\">\n\t\t<div class=\"menu-primary-tiro-container\"><ul id=\"menu-primary-tiro\" class=\"menu\"><li id=\"menu-item-3048\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-has-children menu-item-3048\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/\" data-ps2id-api=\"true\">Care Recommendations<\/a>\n<ul class=\"sub-menu\">\n\t<li id=\"menu-item-4432\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-4432\"><a href=\"#\" data-ps2id-api=\"true\">Differentiated Thyroid Cancer<\/a>\n\t<ul class=\"sub-menu\">\n\t\t<li id=\"menu-item-1987\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1987\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/initial-evaluation-of-thyroid-nodules\/\" data-ps2id-api=\"true\">Initial Evaluation of Thyroid Nodules<\/a><\/li>\n\t\t<li id=\"menu-item-1986\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1986\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/initial-management\/\" data-ps2id-api=\"true\">Initial Management<\/a><\/li>\n\t\t<li id=\"menu-item-1983\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1983\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/initial-staging-response-to-therapy\/\" data-ps2id-api=\"true\">Initial Staging &#038; Response to Therapy<\/a><\/li>\n\t\t<li id=\"menu-item-1984\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1984\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/systemic-therapy\/\" data-ps2id-api=\"true\">Systemic Therapy<\/a><\/li>\n\t\t<li id=\"menu-item-1985\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1985\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/use-of-rai\/\" data-ps2id-api=\"true\">Use of Radioactive Iodine<\/a><\/li>\n\t\t<li id=\"menu-item-1982\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1982\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/dtc\/recurrent-persistent-disease\/\" data-ps2id-api=\"true\">Recurrent &#038; Persistent Disease<\/a><\/li>\n\t<\/ul>\n<\/li>\n\t<li id=\"menu-item-4433\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-4433\"><a href=\"#\" data-ps2id-api=\"true\">Medullary Thyroid Cancer<\/a>\n\t<ul class=\"sub-menu\">\n\t\t<li id=\"menu-item-4465\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4465\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/mtc\/initial-evaluation-of-thyroid-nodules-suspicious-of-mtc\/\" data-ps2id-api=\"true\">Initial Evaluation of Thyroid Nodules Suspicious of MTC<\/a><\/li>\n\t\t<li id=\"menu-item-4467\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4467\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/mtc\/surgical-management\/\" data-ps2id-api=\"true\">Surgical Management<\/a><\/li>\n\t\t<li id=\"menu-item-4862\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4862\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/mtc\/evaluation-of-advanced-disease\/\" data-ps2id-api=\"true\">Evaluation of Advanced Disease<\/a><\/li>\n\t\t<li id=\"menu-item-4466\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4466\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/mtc\/management-of-specific-clinical-scenarios\/\" data-ps2id-api=\"true\">Management of Specific Clinical Scenarios<\/a><\/li>\n\t<\/ul>\n<\/li>\n\t<li id=\"menu-item-4434\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-4434\"><a href=\"#\" data-ps2id-api=\"true\">Anaplastic Thyroid Cancer<\/a>\n\t<ul class=\"sub-menu\">\n\t\t<li id=\"menu-item-4502\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4502\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/atc\/diagnostic-procedures\/\" data-ps2id-api=\"true\">Diagnostic Procedures<\/a><\/li>\n\t\t<li id=\"menu-item-4501\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4501\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/atc\/initial-staging-treatment-planning\/\" data-ps2id-api=\"true\">Initial Staging &#038; Treatment Planning<\/a><\/li>\n\t\t<li id=\"menu-item-4500\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4500\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/atc\/surgical-management\/\" data-ps2id-api=\"true\">Surgical Management<\/a><\/li>\n\t\t<li id=\"menu-item-4499\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4499\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/atc\/systemic-therapy\/\" data-ps2id-api=\"true\">Systemic Therapy<\/a><\/li>\n\t\t<li id=\"menu-item-4498\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4498\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/atc\/end-of-life-care\/\" data-ps2id-api=\"true\">End of Life Care<\/a><\/li>\n\t<\/ul>\n<\/li>\n\t<li id=\"menu-item-29263\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-29263\"><a href=\"#\" data-ps2id-api=\"true\">Analysis Tools<\/a>\n\t<ul class=\"sub-menu\">\n\t\t<li id=\"menu-item-29264\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-29264\"><a href=\"https:\/\/tiro.expert\/es\/ata-2025-risk-of-recurrence-calculator\/\" data-ps2id-api=\"true\">Risk of Recurrence Calculator<\/a><\/li>\n\t\t<li id=\"menu-item-20846\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-20846\"><a href=\"https:\/\/tiro.expert\/es\/recommendations\/analysis-tools\/\" data-ps2id-api=\"true\">Anatomic Checklist for Thyroid Cancer<\/a><\/li>\n\t<\/ul>\n<\/li>\n\t<li id=\"menu-item-1990\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1990\"><a href=\"https:\/\/tiro.expert\/es\/clinical-trial-options\/\" data-ps2id-api=\"true\">Clinical Trial Options<\/a><\/li>\n\t<li id=\"menu-item-3818\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-3818\"><a href=\"https:\/\/tiro.expert\/es\/tables-and-figures\/\" data-ps2id-api=\"true\">Tables &#038; Figures<\/a><\/li>\n<\/ul>\n<\/li>\n<li id=\"menu-item-1973\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-1973\"><a href=\"#\" data-ps2id-api=\"true\">Events<\/a>\n<ul class=\"sub-menu\">\n\t<li id=\"menu-item-4348\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-4348\"><a href=\"https:\/\/tiro.expert\/es\/webinars\/\" data-ps2id-api=\"true\">Upcoming Webinars<\/a><\/li>\n\t<li id=\"menu-item-20057\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-20057\"><a href=\"https:\/\/tiro.expert\/es\/past-webinars\/\" data-ps2id-api=\"true\">Past Webinars<\/a><\/li>\n\t<li id=\"menu-item-1975\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-1975\"><a href=\"\/subscribe\" data-ps2id-api=\"true\">Subscribe <i class=\"fas fa-external-link-alt fa-xs fa-fw\"><\/i><\/a><\/li>\n<\/ul>\n<\/li>\n<li id=\"menu-item-1974\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-has-children menu-item-1974\"><a href=\"#\" data-ps2id-api=\"true\">About TIRO<\/a>\n<ul class=\"sub-menu\">\n\t<li id=\"menu-item-1977\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1977\"><a href=\"https:\/\/tiro.expert\/es\/what-is-tiro\/\" data-ps2id-api=\"true\">What is TIRO?<\/a><\/li>\n\t<li id=\"menu-item-2407\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-2407\"><a href=\"https:\/\/tiro.expert\/es\/how-to-use-tiro\/\" data-ps2id-api=\"true\">How to Use TIRO<\/a><\/li>\n\t<li id=\"menu-item-1978\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-1978\"><a href=\"https:\/\/tiro.expert\/es\/contact\/\" data-ps2id-api=\"true\">Contact<\/a><\/li>\n\t<li id=\"menu-item-1979\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-1979\"><a href=\"https:\/\/thancguide.org\/\" data-ps2id-api=\"true\">THANC Guide <i class=\"fas fa-external-link-alt fa-xs fa-fw\"><\/i><\/a><\/li>\n\t<li id=\"menu-item-1980\" class=\"menu-item menu-item-type-custom menu-item-object-custom menu-item-1980\"><a href=\"https:\/\/thancfoundation.org\" data-ps2id-api=\"true\">THANC Foundation <i class=\"fas fa-external-link-alt fa-xs fa-fw\"><\/i><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul><\/div>\t<\/div>\n<\/div>\n<div class=\"clinical-outline-mask\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading has-secondary-color has-text-color\">Management Recommendations<\/h2>\n\n\n\n<h3 class=\"wp-block-heading tw-mb-0\">1. RAI Refractory Metastatic Disease<\/h3>\n\n\n\n<p class=\"guidelines wp-block-paragraph\">ATA \/\/ ESMO \/\/ JAES \/\/ NCCN<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">A. Role of Resensitization for RAIR Disease<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>In radioiodine refractory thyroid cancer several small studies have demonstrated the proof of principle that inhibitors of the MAPK pathway, such as selumetinib, dabrafenib and vemurafenib, can restore RAI avidity in some cases. Patients with RAI refractory DTC that is indolent should be considered for clinical trials investigating RAI resensitization.<span id=\"ec0f8ca7-25b3-46fd-bcce-7ac1c879099f\" data-items=\"[&quot;1669419985&quot;,&quot;3102056739&quot;,&quot;1160858975&quot;]\" class=\"abt-citation\" data-has-children=\"true\" contenteditable=\"false\"><sup>\u200b1\u20133\u200b<\/sup><\/span><\/li>\n<\/ul>\n\n\n\n<p class=\"faux-heading has-h-6-font-size wp-block-paragraph\"><strong>Expert Commentary<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">There exists a major unmet need for optimal treatment options for patients with low-volume, slow-growing RAI refractory DTC. There is significant interest in the potential role for resensitization in this setting, pointing to a major imperative for definitive clinical trials to be conducted.<\/p>\n\n\n\n<div id=\"edu-1a\" class=\"wp-block-group tw-mb-6 edu-info tw-rounded has-white-background-color has-background tw-shadow tw-top-shape-arc\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Supplemental Educational Content<\/p>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-accordion lecture gb-block-accordion\"><details><summary class=\"gb-accordion-title\">Agnostic Approach to Targeted Therapy<\/summary><div class=\"gb-accordion-text\">\n<p class=\"tw-eyebrow tw-heading-border-bottom faux-heading has-h-6-font-size wp-block-paragraph\">Presenter: Jochen Lorch, MD, MS<\/p>\n\n\n\n<p class=\"faux-heading has-h-5-font-size wp-block-paragraph\">Summary<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Dr. Jochen Lorch discusses various targeted therapies and their impact on the prognosis in RAI refractory differentiated thyroid cancer, medullary thyroid cancer, and anaplastic thyroid cancer.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">More aggressive types of thyroid cancer are increasing in frequency.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Differentiated thyroid cancer has a generally bland genomic landscape compared to other types of cancers, however in poorly differentiated and anaplastic thyroid cancer the landscape becomes more active and there is greater mutational burden.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When differentiated thyroid cancer recurs, RAI treatment does have the possibility of leading to complete remission, though this is also dependent on the size of the lesion.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In many cases, RAI refractory eventually develops which requires systemic therapy.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Tyrosine Kinase Inhibitors were the first type of drug developed to treat RAI refractory.<\/li>\n\n\n\n<li>Dr. Lorch highlights a multitude of phase III trials for drugs, some of which have been FDA approved, targeting RAI refractory thyroid cancer.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/youtu.be\/sEAMRxR-g_c\" target=\"_blank\" rel=\"noreferrer noopener\"><i class=\"fab fa-fw fa-youtube\"><\/i> Watch this session<\/a><\/div>\n<\/div>\n<\/div><\/details><\/div>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-accordion lecture gb-block-accordion\"><details><summary class=\"gb-accordion-title\">Selumetinib Plus Adjuvant Radioactive Iodine in Patients with High-Risk Differentiated Thyroid Cancer<\/summary><div class=\"gb-accordion-text\">\n<p class=\"faux-heading tw-eyebrow tw-heading-border-bottom has-h-6-font-size wp-block-paragraph\">Presenter: Alan Ho, MD<\/p>\n\n\n\n<ul class=\"is-style-tw-border-inner wp-block-list\">\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=1Xejnaq_rjU&amp;t=262s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>4:22<\/strong><\/a><strong> &#8211; How Can Selumetinib Enhance RAI Uptake?<\/strong><br>Dr. Ho provides some biochemical background on how selumetinib can be used to inhibit the MAPK pathway and enhance RAI uptake.<\/li>\n\n\n\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=1Xejnaq_rjU&amp;t=632s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>10:32<\/strong><\/a><strong> &#8211; Designing the ASTRA Clinical Trial<\/strong><br>Dr. Ho outlines the design of the ASTRA Phase III study, discussing the rationale behind setting specific inclusion\/exclusion criteria and endpoints.<\/li>\n\n\n\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=1Xejnaq_rjU&amp;t=1277s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>21:17<\/strong><\/a><strong> &#8211; What Does Selumetinib Affect?<\/strong><br>Dr. Ho summarizes the results of the study, explaining that administering selumetinib with RAI did not have significantly more benefit than administering RAI alone.<\/li>\n\n\n\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=1Xejnaq_rjU&amp;t=1573s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>26:13<\/strong><\/a><strong> &#8211; What\u2019s Next for Selumetinib?<\/strong><br>Dr. Ho discusses strengths and limitations from the ASTRA trial and how they might influence future study design.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/youtu.be\/1Xejnaq_rjU\" target=\"_blank\" rel=\"noreferrer noopener\"><i class=\"fab fa-fw fa-youtube\"><\/i> Watch this session<\/a><\/div>\n<\/div>\n<\/div><\/details><\/div>\n<\/div><\/div>\n\n\n\n<h4 class=\"wp-block-heading\">B. Multikinase Inhibitors<\/h4>\n\n\n\n<h5 class=\"wp-block-heading\">i. When to Start\/Stop Therapy<\/h5>\n\n\n\n<h6 class=\"wp-block-heading\">Regulatory Approvals<\/h6>\n\n\n\n<p class=\"wp-block-paragraph\">Sorafenib and lenvatinib are both approved for the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory (RAI-refractory) differentiated thyroid cancer (DTC).<\/p>\n\n\n\n<div id=\"edu-1b\" class=\"wp-block-group edu-info tw-rounded has-white-background-color has-background tw-shadow\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n\n<p class=\"wp-block-paragraph\">Supplemental Educational Content<\/p>\n\n\n<div class=\"wp-block-genesis-blocks-gb-accordion presentation gb-block-accordion\"><details><summary class=\"gb-accordion-title\">Real-World Treatment Patterns Among Patients Initiating Small Molecule Kinase Inhibitor Therapies for Thyroid Cancer in the United States<\/summary><div class=\"gb-accordion-text\">\n\n<h6 class=\"tw-eyebrow tw-heading-border-bottom wp-block-heading\">Presenter: Frank Worden, MD<\/h6>\n\n\n<p class=\"wp-block-paragraph\">Dr. Frank Worden presents a lecture on treatment patterns among thyroid cancer patients treated with small molecule kinase inhibitor (SMKI) therapies. Dr. Eric Sherman analyzes the strengths and weaknesses of this study and explores possible next steps.<\/p>\n\n\n<ul class=\"wp-block-list\"><li>Dr. Worden discusses the different types of thyroid cancers, their prevalence, and the type of cells they arise from (4:37)<\/li><li>Dr. Worden summarizes the FDA approval timeline for different SMKIs between the years of 2011 and 2020 (6:08)<\/li><li>This study concluded that SMKI second- and third-line treatment for thyroid cancer patients shows potential survival benefits<\/li><li>Dr. Sherman suggests that determining effective sequencing of SMKI therapies will be important if thyroid cancer patients are truly requiring multiple lines of treatment<\/li><li>Dr. Sherman examines the limitations of this study (41:34) as well as its real-life applications (53:33)<\/li><\/ul>\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link\" href=\"https:\/\/youtu.be\/e94T4heYDTQ\" target=\"_blank\" rel=\"noreferrer noopener\"><i class=\"fab fa-fw fa-youtube\"><\/i> Watch this session<\/a><\/div>\n\n<\/div>\n\n<\/div><\/details><\/div>\n\n<\/div><\/div>\n\n\n\n<h4 class=\"wp-block-heading\">C. Managing Toxicities of Therapy<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Because potential toxicities can negatively impact quality of life or even be fatal, patients must be appropriately selected for therapy and closely monitored after starting therapy.<span id=\"0ecb9b60-75fe-4c37-a00a-a32032df6f58\" data-items=\"[&quot;1669419985&quot;,&quot;3102056739&quot;,&quot;454795586&quot;]\" data-has-children=\"true\" class=\"abt-citation\" contenteditable=\"false\"><sup>\u200b1,2,4\u200b<\/sup><\/span><\/li>\n\n\n\n<li>Adverse events caught early can be effectively managed, but prevention, when feasible, is always advisable. The ultimate goal is to manage side-effects without having detrimental effects on treatment efficacy.<span id=\"85f21661-cf28-4787-865c-32b366fecf26\" data-items=\"[&quot;3102056739&quot;,&quot;454795586&quot;]\" data-has-children=\"true\" class=\"abt-citation\" contenteditable=\"false\"><sup>\u200b2,4\u200b<\/sup><\/span><\/li>\n\n\n\n<li>Due to the risk of fetal harm and the potential for infertility, fertility preservation approaches and pregnancy testing should be discussed before starting treatment.<span id=\"50314bee-442b-4a4f-a3ae-431b8ee15b47\" data-items=\"[&quot;454795586&quot;]\" data-has-children=\"true\" class=\"abt-citation\" contenteditable=\"false\"><sup>\u200b4\u200b<\/sup><\/span><\/li>\n\n\n\n<li>Informed patient consent should be done prior to initiating therapy.<span id=\"1a75b9a1-50d6-4c9a-a72e-0d69012ab2a4\" data-items=\"[&quot;3102056739&quot;]\" class=\"abt-citation\" data-has-children=\"true\" contenteditable=\"false\"><sup>\u200b2\u200b<\/sup><\/span><\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading tw-mb-0\">2. Consideration for Patients Who Fail Therapy<\/h3>\n\n\n\n<p class=\"guidelines wp-block-paragraph\">ATA \/\/ ESMO \/\/ NCCN<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Clinical trials should be considered for second-line therapy.<span id=\"415c17a0-63e0-48fd-959a-35ae9f98233c\" data-items=\"[&quot;1669419985&quot;,&quot;1160858975&quot;]\" data-has-children=\"true\" class=\"abt-citation\" contenteditable=\"false\"><sup>\u200b1,3\u200b<\/sup><\/span><\/li>\n\n\n\n<li>Patients who progress through first-line kinase inhibitor therapy should be considered candidates for second-line kinase inhibitor therapy, and therapy should be continued until any of the following occurs:\n<ul class=\"wp-block-list\">\n<li>Disease progression,<\/li>\n\n\n\n<li>Unacceptable toxicities, or<\/li>\n\n\n\n<li>Patient desires to stop treatment.<span id=\"43b9863e-d4e4-4411-bf5a-b98eb0be7427\" data-items=\"[&quot;1669419985&quot;,&quot;1160858975&quot;,&quot;454795586&quot;]\" data-has-children=\"true\" class=\"abt-citation\" contenteditable=\"false\"><sup>\u200b1,3,4\u200b<\/sup><\/span><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>If there are no clinical trials to enroll patients, commercially available small-molecule inhibitors, such as axitinib, everolimus, pazopanib, suntinib, vandetinib, vemurafenib (BRAF positive), dabrafenib (BRAF positive, or cabozantinib can be considered as subsequent therapy.<span id=\"da70dcc9-1d68-4414-854c-946cf3fab008\" data-items=\"[&quot;1160858975&quot;]\" class=\"abt-citation\" data-has-children=\"true\" contenteditable=\"false\"><sup>\u200b3\u200b<\/sup><\/span><\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">3. Neoadjuvant Therapy &amp; Decision-making About Surgery with Systemic Therapy<\/h3>\n\n\n\n<p class=\"faux-heading has-h-6-font-size wp-block-paragraph\"><strong>Expert Commentary<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Decisions regarding the use of systemic therapy in combination with other locoregional therapies such as surgery and external beam radiation therapy for patients with locoregionally advanced and\/or recurrent differentiated thyroid cancer are complex and require multidisciplinary input, with consideration of the following factors (among others):\n<ul class=\"wp-block-list\">\n<li>Biology of the disease, including extent and rate of progression of locoregional and distant disease.<\/li>\n\n\n\n<li>Available targeted therapies, including efficacy and side effect profiles.<\/li>\n\n\n\n<li>Patient-specific factors, including comorbidities, perceived ability to tolerate systemic therapy and local therapies, and patient preference.&nbsp;<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Most patients with differentiated thyroid cancer do not have rapid disease progression, and therefore neoadjuvant systemic therapy approaches are rarely considered.\u00a0 However, for rare DTC patients with fast-growing tumors and high disease burden, this approach may be considered to reduce the morbidity of surgery or to improve the opportunity for complete surgical resection, particularly for the following:\n<ul class=\"wp-block-list\">\n<li>Patients with targetable mutations or with RET or NTRK fusion.&nbsp;<\/li>\n\n\n\n<li>Patients who have residual\/recurrent disease following previous surgery, as neoadjuvant systemic therapy strategies can potentially prolong the time interval to the next surgery.&nbsp;&nbsp;<\/li>\n\n\n\n<li>Patients with locoregionally advanced disease and\/or residual\/recurrent disease who would require morbid surgery (e.g. sacrifice of recurrent laryngeal nerve or laryngectomy) for complete extirpation of disease, as neoadjuvant strategies can potentially prolong the time to the morbidity associated with this surgery.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Clinical trials are needed to further study the potential benefits and risks of therapeutic approaches combining targeted systemic therapy and surgery.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading tw-mb-0\">4. The Role of External Beam Radiotherapy (EBRT)<\/h3>\n\n\n\n<p class=\"guidelines wp-block-paragraph\">ATA \/\/ AHNS \/\/ JAES \/\/ NCCN<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">A. Locally Advanced DTC<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">EBRT may be considered where there is residual gross unresectable macroscopic disease that is unlikely to be controlled by radioiodine or where it threatens critical structures or organs.<span id=\"d481f123-262a-4c69-8006-f6ba58be2a84\" data-items=\"[&quot;1669419985&quot;,&quot;1160858975&quot;,&quot;454795586&quot;,&quot;1110292741&quot;]\" class=\"abt-citation\" data-has-children=\"true\" contenteditable=\"false\"><sup>\u200b1,3\u20135\u200b<\/sup><\/span><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">B. Locally Recurrent DTC<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">EBRT may be considered where there is gross unresectable macroscopic disease that is unlikely to be controlled by radioiodine or where it threatens critical structures or organs.<span id=\"5facf003-c724-455d-a802-228760340790\" data-items=\"[&quot;1669419985&quot;,&quot;1160858975&quot;,&quot;454795586&quot;]\" class=\"abt-citation\" data-has-children=\"true\" contenteditable=\"false\"><sup>\u200b1,3,4\u200b<\/sup><\/span><\/p>\n\n\n\n<h3 class=\"wp-block-heading tw-mb-0\">5. Cytotoxic Chemotherapy<\/h3>\n\n\n\n<p class=\"guidelines wp-block-paragraph\">ATA \/\/ ESMO \/\/ NCCN<\/p>\n\n\n\n<p class=\"faux-heading has-h-6-font-size wp-block-paragraph\">Regulatory Approvals<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Doxorubicin is FDA approved for thyroid cancer.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>In radioiodine refractory thyroid cancer, there is no strong evidence indicating clinical benefit for cytotoxic chemotherapy. However, cytotoxic chemotherapy may be considered in select cases.<span id=\"7cdfa6c1-72f8-425e-a021-af907217a165\" data-items=\"[&quot;1669419985&quot;,&quot;1160858975&quot;,&quot;454795586&quot;]\" class=\"abt-citation\" data-has-children=\"true\" contenteditable=\"false\"><sup>\u200b1,3,4\u200b<\/sup><\/span><\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading tw-mb-0\">6. Bisphosphonate\/Rank Ligand Inhibitor<\/h3>\n\n\n\n<p class=\"guidelines wp-block-paragraph\">ATA \/\/ ESMO \/\/ NCCN<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Bone directed treatment; bisphosphonates or denosumab should be considered in patients with diffuse thyroid cancer bone metastases.<\/li>\n<\/ul>\n\n\n\n<div id=\"aod-0\" class=\"wp-block-group\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"wp-block-genesis-blocks-gb-accordion aod gb-block-accordion\"><details><summary class=\"gb-accordion-title\">Bone Directed Treatment<\/summary><div class=\"gb-accordion-text\">\n<p class=\"guidelines wp-block-paragraph\">ATA &amp; NCCN vs. ESMO<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">RR-DTC (ATA NCCN) vs. all metastatic DTC (ESMO)<\/p>\n<\/div><\/details><\/div>\n<\/div><\/div>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Baseline dental review is advised due to risk of osteonecrosis of the mandible. Serum calcium and vitamin D levels should be checked before administration of bisphosphonates or denosumab and levels maintained with supplements if necessary.<\/li>\n\n\n\n<li>Frequency of administration may be every 4 weeks (bisphosphonate and denosumab) or every 12 weeks for bisphosphonate.<\/li>\n<\/ul>\n\n\n\n<div id=\"aod-1\" class=\"wp-block-group\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"wp-block-genesis-blocks-gb-accordion aod gb-block-accordion\"><details><summary class=\"gb-accordion-title\">Bisphosphonate Frequency<\/summary><div class=\"gb-accordion-text\">\n<p class=\"guidelines wp-block-paragraph\">ATA vs. ESMO<\/p>\n<\/div><\/details><\/div>\n<\/div><\/div>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Once initiated, the minimum duration of treatment should be 2 years.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading tw-mb-0\">7. Targeted Therapies Against Specific Tumor Alterations<\/h3>\n\n\n\n<p class=\"guidelines wp-block-paragraph\">ATA \/\/ ESMO \/\/ NCCN<\/p>\n\n\n\n<p class=\"faux-heading has-h-6-font-size wp-block-paragraph\">Regulatory Approvals<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Larotrectinib and entrectinib are FDA approved for NTRK fusion-positive advanced cancers. selpercatinib and pralsetinib are FDA approved for advanced RET fusion-positive thyroid cancers. Larotrectinib is European Medicines Agency approved.&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>In advanced unresectable and\/or metastatic radioiodine refractory thyroid cancer, data support gene-specific therapy.&nbsp;&nbsp;<\/li>\n\n\n\n<li>A TRK-specific drug may be considered in patients with NTRK fusion-positive advanced unresectable and\/or metastatic radioiodine refractory thyroid cancer who are deemed to be in need of systemic therapy.&nbsp;&nbsp;<\/li>\n\n\n\n<li>Patients with RET fusion-positive advanced unresectable and\/or metastatic radioiodine refractory thyroid cancer in need of systemic therapy may be treated with a RET-specific drug, where available.&nbsp;&nbsp;<\/li>\n\n\n\n<li>BRAF-specific inhibitors have demonstrated potential benefits for treating patients with BRAF V600E mutation-positive advanced unresectable and\/or metastatic radioiodine refractory thyroid cancer who are deemed to be in need of systemic therapy&nbsp;<\/li>\n\n\n\n<li>ALK fusions drive a small percentage of DTCs. Several case reports are available detailing activity of ALK-specific inhibitors.&nbsp;&nbsp;<\/li>\n\n\n\n<li>There are no targeted therapies that have emerged that offer clear benefit to RAS mutation-positive advanced unresectable and\/or metastatic radioiodine refractory thyroid cancer. Participation in gene-specific clinical trials is strongly encouraged.<span id=\"b8c06d20-b227-4f5f-b05d-3c401ab3f66f\" data-items=\"[&quot;1669419985&quot;,&quot;1160858975&quot;,&quot;454795586&quot;]\" class=\"abt-citation\" data-has-children=\"true\" contenteditable=\"false\"><sup>\u200b1,3,4\u200b<\/sup><\/span><\/li>\n<\/ul>\n\n\n\n<div id=\"edu-7\" class=\"wp-block-group tw-mb-9 edu-info tw-rounded has-white-background-color has-background tw-shadow tw-top-shape-arc\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Supplemental Educational Content<\/p>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-accordion presentation gb-block-accordion\"><details><summary class=\"gb-accordion-title\">Systemic Therapy in Thyroid Neoplasms<\/summary><div class=\"gb-accordion-text\">\n<p class=\"faux-heading tw-eyebrow tw-heading-border-bottom has-h-6-font-size wp-block-paragraph\">Presenter: Lori Wirth, MD<\/p>\n\n\n\n<p class=\"faux-heading has-h-5-font-size wp-block-paragraph\">Summary<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Drs. Worth and Ho give an excellent background on the current standard and emerging therapies for <\/strong><strong><em>RET<\/em><\/strong><strong> proto-oncogene mutations in thyroid cancers.&nbsp;<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>This week, we are thrilled to welcome Dr. Lori Worth and Dr. Alan Ho. Dr. Wirth is a medical oncologist and the Elizabeth and Michael Ruane Endowed Chair of Medical Oncology at the Massachusetts General Hospital Cancer Center. She is a leading authority in advanced thyroid cancer and head and neck oncology. Dr. Ho is our discussant for this lecture and is the Geoffrey een Junior Faculty Chair of Oncology at the Memorial Sloan Kettering Cancer Center.<\/li>\n\n\n\n<li>Dr. Wirth discussed the details of targeting and managing the <em>RET <\/em>proto-oncogene in thyroid cancers. This gene encodes a specific tyrosine kinase receptor that, when unregulated due to mutation, is associated with the development of various types of cancer. Dr. Wirth narrows in on involvement of <em>RET<\/em> mutations in medullary thyroid cancer (MTC) and papillary thyroid cancer (PTC). With regards to PTC, <em>RET<\/em> mutations are more common in pediatric and young adults.&nbsp;<\/li>\n\n\n\n<li>There are now two highly potent <em>RET<\/em> inhibitors that have completed first-in-human trials, <strong>Selpercatinib<\/strong> and <strong>Prasetinib. <\/strong>These agents were designed to specifically inhibit the wild-type <em>RET <\/em>kinase seen in the driving mutations of thyroid cancer while sparing other normal kinase activity. Patient recorded outcomes after receiving one of these treatments indicate that the majority either remained stable or improved, both in terms of pain reduction and overall quality of life. This is a significant improvement from the previous multikinase inhibitors that are too general and thus cause damaging off-target toxicity.<\/li>\n\n\n\n<li>With regards to the future directions of <em>RET<\/em>-specific therapy, trials for LIBRETTO-531 recently opened for accrual and are comparing the novel Selpercatinib to either Cabozantinib or Vandetanib based on the physicians choice. It is intended for patients with progressive, advanced, <em>RET<\/em>-based medullary thyroid cancer.<\/li>\n\n\n\n<li>Dr. Ho complements Dr. Wirth\u2019s discussion with a lecture on the previous standard therapies for <em>RET <\/em>inhibition and how this compares to selective <em>RET<\/em> inhibitors for <em>RET<\/em>-altered tumors.<\/li>\n\n\n\n<li>The success of these newer <em>RET<\/em>-specific inhibitors is due to the advancements in drug chemistry that allow developers to isolate the molecular structure of <em>RET<\/em>.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/youtu.be\/aU3JOehLRxY\" target=\"_blank\" rel=\"noreferrer noopener\"><i class=\"fab fa-fw fa-youtube\"><\/i> Watch this session<\/a><\/div>\n<\/div>\n<\/div><\/details><\/div>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-accordion presentation gb-block-accordion\"><details><summary class=\"gb-accordion-title\">Detection of BRAF<sup>V600E<\/sup> by Digital PCR on Fine-needle Aspirate Enables Rapid Initiation of Dabrafenib and Trametinib in Unresectable Anaplastic Thyroid Carcinoma<\/summary><div class=\"gb-accordion-text\">\n<p class=\"faux-heading tw-eyebrow tw-heading-border-bottom has-h-6-font-size wp-block-paragraph\">Presenter: Camille Buffet, MD<\/p>\n\n\n\n<p class=\"faux-heading has-h-5-font-size wp-block-paragraph\">Summary<\/p>\n\n\n\n<ul class=\"is-style-tw-border-inner wp-block-list\">\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=BcmhkItTlQM&amp;t=218s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>3:38<\/strong><\/a><strong> \u2014 Key Steps in the Diagnosis and Management of ATC<\/strong><br>Dr. Buffet gives an overview of the key steps in diagnosing and managing anaplastic thyroid cancer that she further details throughout her presentation. She discusses ultrasound, biopsy, CT, PET\/CT, molecular profiling, and care coordination.<a href=\"https:\/\/www.youtube.com\/watch?v=BcmhkItTlQM&amp;t=1050s\">\u00a0<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=BcmhkItTlQM&amp;t=1050s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>17:30<\/strong><\/a><strong> \u2014 Two Example Cases<\/strong><br>Dr. Buffet details two examples of patients tested for BRAF mutation by droplet digital PCR managed at Piti\u00e9 Salp\u00eatri\u00e8re University Hospital in Paris.<\/li>\n\n\n\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=BcmhkItTlQM&amp;t=2035s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>33:55<\/strong><\/a><strong> \u2014 Survival Depends on Mutation<\/strong><br>Dr. Dadu explains that &#8220;By understanding molecular profile, we can understand survival based on mutation.&#8221; RAS mutated ATC is associated with poorer prognosis than BRAF V600E mutation.<a href=\"https:\/\/www.youtube.com\/watch?v=BcmhkItTlQM&amp;t=2696s\">\u00a0<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=BcmhkItTlQM&amp;t=2696s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>44:56<\/strong><\/a><strong> \u2014 Clinical Trial<\/strong><br>Dr. Dadu details the 3 phases of the neoadjuvant clinical trial for patients with a BRAF mutation that became the standard of care in many places.\u00a0<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/www.youtube.com\/watch?v=BcmhkItTlQM\" target=\"_blank\" rel=\"noreferrer noopener\"><i class=\"fab fa-fw fa-youtube\"><\/i> Watch this session<\/a><\/div>\n<\/div>\n<\/div><\/details><\/div>\n<\/div><\/div>\n\n\n\n<h3 class=\"wp-block-heading tw-mb-0\">8. Indications for Somatic Tumor Genetic Testing (DNA\/RNA)<\/h3>\n\n\n\n<p class=\"guidelines wp-block-paragraph\">ESMO \/\/ NCCN<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">A. Aggressive Tumor Types, Progressive Metastases, RAI Refractory Disease<\/h4>\n\n\n\n<p class=\"faux-heading has-h-6-font-size wp-block-paragraph\">Regulatory Approvals<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>In advanced, progressing radioiodine refractory thyroid cancer, patients should be considered for clinical trials. In the absence of an appropriate clinical trial, somatic tumor genetic testing should be considered to identify actionable targets such as:\n<ul class=\"wp-block-list\">\n<li>BRAF mutations (US FDA approval for anaplastic thyroid cancer).<\/li>\n\n\n\n<li>RET mutations (US FDA approval for medullary thyroid cancer).<\/li>\n\n\n\n<li>NTRK fusions (US FDA agnostic indication).<\/li>\n\n\n\n<li>RET fusions (US FDA approval for RET-mutated thyroid cancer including medullary, differentiated and anaplastic thyroid cancer. <\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>In addition, assessment of tumor mutational burden should be considered for progressive radioactive iodine refractory thyroid cancer, with consideration for immunotherapy in patients with high mutational burden.<\/li>\n<\/ul>\n\n\n\n<div id=\"edu-8\" class=\"wp-block-group tw-mb-9 edu-info tw-rounded has-white-background-color has-background tw-shadow tw-top-shape-arc\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Supplemental Educational Content<\/p>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-accordion lecture gb-block-accordion\"><details><summary class=\"gb-accordion-title\">Clinical Application of Next-Generation Sequencing in Advanced Thyroid Cancers<\/summary><div class=\"gb-accordion-text\">\n<p class=\"faux-heading tw-eyebrow tw-heading-border-bottom has-h-6-font-size wp-block-paragraph\">Presenter: Monika Krzyzanowska, MD<\/p>\n\n\n\n<p class=\"faux-heading has-h-5-font-size wp-block-paragraph\">Summary<\/p>\n\n\n\n<ul class=\"is-style-tw-border-inner wp-block-list\">\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=U8NKqD5K9kY&amp;t=376s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>6:16<\/strong><\/a><strong> \u2014 Molecular Alterations &amp; Thyroid Cancer<\/strong><br>Dr. Krzyzanowska provides some background on molecular alterations for various types of thyroid cancer.<a href=\"https:\/\/www.youtube.com\/watch?v=U8NKqD5K9kY&amp;t=1181s\">\u00a0<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=U8NKqD5K9kY&amp;t=1181s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>19:41<\/strong><\/a><strong> \u2014 Categorizing Molecular Alterations in Thyroid Cancer Patients<\/strong><br>Dr. Ma discusses the purpose of the retrospective cohort study she and her team conducted, and summarizes characteristics of patients included in the study.<a href=\"https:\/\/www.youtube.com\/watch?v=U8NKqD5K9kY&amp;t=1344s\">\u00a0<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=U8NKqD5K9kY&amp;t=1344s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>22:24<\/strong><\/a><strong> \u2014 Study Results<\/strong><br>Dr. Ma discusses findings regarding gene mutations for various types of thyroid cancer and treatment outcomes for specific types of mutations.<a href=\"https:\/\/www.youtube.com\/watch?v=U8NKqD5K9kY&amp;t=1858s\">\u00a0<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.youtube.com\/watch?v=U8NKqD5K9kY&amp;t=1858s\" target=\"_blank\" rel=\"noopener\" title=\"\"><strong>30:58<\/strong><\/a><strong> \u2014 Recommendations for Molecular Profiling<\/strong><br>Dr. Krzyzanowska provides recommendations for how molecular profiling should be implemented into thyroid cancer treatment.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/www.youtube.com\/watch?v=U8NKqD5K9kY\" target=\"_blank\" rel=\"noreferrer noopener\"><i class=\"fab fa-fw fa-youtube\"><\/i> Watch this session<\/a><\/div>\n<\/div>\n<\/div><\/details><\/div>\n<\/div><\/div>\n\n\n\n<div id=\"aod-2\" class=\"wp-block-group\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"wp-block-genesis-blocks-gb-accordion aod gb-block-accordion\"><details><summary class=\"gb-accordion-title\">Mutational Burden<\/summary><div class=\"gb-accordion-text\">\n<p class=\"guidelines wp-block-paragraph\">NCCN vs. ESMO<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Partial agreement.<\/p>\n<\/div><\/details><\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile is-vertically-aligned-center is-image-fill tw-mt-9 alignfull is-style-tw-shadow tw-rounded has-violet-08-color has-subtle-background-background-color has-text-color has-background tw-media-bottom tw-stretched-link\" style=\"grid-template-columns:30% auto\"><figure class=\"wp-block-media-text__media\" style=\"background-image:url(https:\/\/tiro.expert\/wp-content\/uploads\/2021\/05\/hb6uwq0i4mi-1024x683.jpg);background-position:67% 52%\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"683\" src=\"https:\/\/tiro.expert\/wp-content\/uploads\/2021\/05\/hb6uwq0i4mi-1024x683.jpg\" alt=\"selective focus photography of people sitting on chairs while writing on notebooks\" class=\"wp-image-2444 size-full\" srcset=\"https:\/\/tiro.expert\/wp-content\/uploads\/2021\/05\/hb6uwq0i4mi-1024x683.jpg 1024w, https:\/\/tiro.expert\/wp-content\/uploads\/2021\/05\/hb6uwq0i4mi-300x200.jpg 300w, https:\/\/tiro.expert\/wp-content\/uploads\/2021\/05\/hb6uwq0i4mi-768x512.jpg 768w, https:\/\/tiro.expert\/wp-content\/uploads\/2021\/05\/hb6uwq0i4mi-1536x1024.jpg 1536w, https:\/\/tiro.expert\/wp-content\/uploads\/2021\/05\/hb6uwq0i4mi-600x400.jpg 600w, https:\/\/tiro.expert\/wp-content\/uploads\/2021\/05\/hb6uwq0i4mi-1200x800.jpg 1200w, https:\/\/tiro.expert\/wp-content\/uploads\/2021\/05\/hb6uwq0i4mi.jpg 1600w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<h2 class=\"wp-block-heading has-violet-08-color has-text-color\">Add TIROxMDS Webinars to Your Calendar<\/h2>\n\n\n\n<p class=\"has-violet-08-color has-text-color wp-block-paragraph\"><strong>In 2 quick steps, you can add our entire schedule of upcoming webinars to your calendar today!<\/strong> That way, you will never miss our upcoming lectures, presentations and case-based studies. Every Friday at 8:00 AM ET, we cover a new topic from published research.<\/p>\n\n\n\n<a title=\"Add to Calendar\" class=\"addeventstc\" data-id=\"wo408159\" href=\"https:\/\/www.addevent.com\/calendar\/wo408159\" target=\"_blank\" rel=\"nofollow noopener\">Add to Calendar<\/a>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-group alignfull tw-mt-9\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"wp-block-group alignfull tw-mt-9\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<h2 class=\"wp-block-heading has-text-align-center tw-mb-6 tw-sm-text-left tw-heading-border-bottom has-violet-color has-text-color has-h-3-font-size\">Upcoming Webinars<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n<div class=\"wp-block-columns alignwide tw-mt-8 tiroxmds-grid tw-cols-rounded tw-cols-stack-md tw-cols-card tw-cols-card-white is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading tw-mb-1 has-h-5-font-size\">Ari Wassner, MD<\/h3>\n\n\n\n<p class=\"has-text-align-left tw-mt-1 tw-text-uppercase tw-letter-spacing-tight has-violet-04-color has-text-color wp-block-paragraph\" style=\"font-size:10px\"><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong>Guest Presenter<\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/p>\n\n\n\n<p class=\"tw-eyebrow tw-letter-spacing-tight has-violet-05-color has-text-color has-small-font-size wp-block-paragraph\"><i class=\"fas fa-fw fa-presentation-screen\"><\/i> <strong>Journal Club<\/strong><\/p>\n\n\n\n<p class=\"has-small-font-size wp-block-paragraph\"><strong><strong><strong><strong>Thyroid Function After Hemithyroidectomy in Children<\/strong><\/strong><\/strong><\/strong><\/p>\n\n\n\n<div class=\"wp-block-group event-actions\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"date wp-block-paragraph\">Nov. 13, 2026<\/p>\n\n\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading tw-mb-1 has-h-5-font-size\">Gabriela Brenta, MD<\/h3>\n\n\n\n<p class=\"has-text-align-left tw-mt-1 tw-text-uppercase tw-letter-spacing-tight has-violet-04-color has-text-color wp-block-paragraph\" style=\"font-size:10px\"><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong>Guest Presenter<\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/p>\n\n\n\n<p class=\"tw-eyebrow tw-letter-spacing-tight has-violet-05-color has-text-color has-small-font-size wp-block-paragraph\"><i class=\"fas fa-fw fa-presentation-screen\"><\/i> <strong>Journal Club<\/strong><\/p>\n\n\n\n<p class=\"has-small-font-size wp-block-paragraph\"><strong><strong><strong><strong>ATA 2026 Guidelines for Thyroid Disease in Preconception, Pregnancy &amp; Post Partum<\/strong><\/strong><\/strong><\/strong><\/p>\n\n\n\n<div class=\"wp-block-group event-actions\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"date wp-block-paragraph\">Nov. 20, 2026<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/evt.to\/r2zbrqhwblsp\" target=\"_blank\" rel=\"noreferrer noopener\"><i class=\"fas fa-fw fa-user-check\"><\/i> RSVP<\/a><\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column has-accent-background-color has-background is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading tw-mb-1 has-violet-04-color has-text-color has-h-5-font-size\">No Webinar<\/h3>\n\n\n\n<p class=\"has-background-color has-text-color has-small-font-size wp-block-paragraph\"><strong><strong>Due to Thanksgiving (US Holiday).<\/strong><\/strong><\/p>\n\n\n\n<div class=\"wp-block-group event-actions\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"date has-violet-05-color has-text-color wp-block-paragraph\">Nov. 27, 2026<\/p>\n<\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns alignwide tw-mt-8 tiroxmds-grid tw-cols-rounded tw-cols-stack-md tw-cols-card tw-cols-card-white is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading tw-mb-1 has-h-5-font-size\">Marika Russell, MD<\/h3>\n\n\n\n<p class=\"has-text-align-left tw-mt-1 tw-text-uppercase tw-letter-spacing-tight has-violet-04-color has-text-color wp-block-paragraph\" style=\"font-size:10px\"><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong>Guest Presenter<\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/p>\n\n\n\n<p class=\"tw-eyebrow tw-letter-spacing-tight has-violet-05-color has-text-color has-small-font-size wp-block-paragraph\"><i class=\"fas fa-fw fa-presentation-screen\"><\/i> <strong>Journal Club<\/strong><\/p>\n\n\n\n<p class=\"has-small-font-size wp-block-paragraph\"><strong><strong><strong><strong>Scholarly Dialogue on Risk to the Recurrent Laryngeal Nerve with Thermal Ablation Procedures: A Reflection on Empirical Practices.<\/strong><\/strong><\/strong><\/strong><\/p>\n\n\n\n<div class=\"wp-block-group event-actions\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"date wp-block-paragraph\">Dec. 4, 2026<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/evt.to\/8qxr8bgvhxjm\" target=\"_blank\" rel=\"noreferrer noopener\"><i class=\"fas fa-fw fa-user-check\"><\/i> RSVP<\/a><\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading tw-mb-1 has-h-5-font-size\">Michael Tuttle, MD<\/h3>\n\n\n\n<p class=\"has-text-align-left tw-mt-1 tw-text-uppercase tw-letter-spacing-tight has-violet-04-color has-text-color wp-block-paragraph\" style=\"font-size:10px\"><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong>Moderator<\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/p>\n\n\n\n<p class=\"tw-eyebrow tw-letter-spacing-tight has-violet-05-color has-text-color has-small-font-size wp-block-paragraph\"><i class=\"fas fa-fw fa-comments\"><\/i> <strong>Tumor Board<\/strong><\/p>\n\n\n\n<p class=\"has-small-font-size wp-block-paragraph\"><strong><strong><strong><strong>Cases presen<\/strong><\/strong><\/strong>ted by Dr. Andy Bauer<\/strong><\/p>\n\n\n\n<div class=\"wp-block-group event-actions\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"date wp-block-paragraph\">Dec. 11, 2026<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/evt.to\/9td6xgn8slvc\" target=\"_blank\" rel=\"noreferrer noopener\"><i class=\"fas fa-fw fa-user-check\"><\/i> RSVP<\/a><\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h3 class=\"wp-block-heading tw-mb-1 has-h-5-font-size\">Johnson Thomas, MD<\/h3>\n\n\n\n<p class=\"has-text-align-left tw-mt-1 tw-text-uppercase tw-letter-spacing-tight has-violet-04-color has-text-color wp-block-paragraph\" style=\"font-size:10px\"><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong><strong>Guest Presenter<\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/p>\n\n\n\n<p class=\"tw-eyebrow tw-letter-spacing-tight has-violet-05-color has-text-color has-small-font-size wp-block-paragraph\"><i class=\"fas fa-fw fa-presentation-screen\"><\/i> <strong>Journal Club<\/strong><\/p>\n\n\n\n<p class=\"has-small-font-size wp-block-paragraph\"><strong><strong><strong><strong>Artificial Intelligence Applications in Thyroid Cancer Diagnosis: 2026 Update<\/strong><\/strong><\/strong><\/strong><\/p>\n\n\n\n<div class=\"wp-block-group event-actions\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n<p class=\"date wp-block-paragraph\">Dec. 18, 2026<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/evt.to\/ngl44hcwp9cn\" target=\"_blank\" rel=\"noreferrer noopener\"><i class=\"fas fa-fw fa-user-check\"><\/i> RSVP<\/a><\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-media-text alignwide has-media-on-the-right is-stacked-on-mobile is-vertically-aligned-center is-image-fill tw-mt-9 alignfull is-style-tw-shadow tw-rounded tw-media-bottom tw-stretched-link\" style=\"grid-template-columns:auto 49%\"><div class=\"wp-block-media-text__content\">\n<h2 class=\"wp-block-heading has-text-align-center has-violet-08-color has-text-color\">Watch Past Videos<\/h2>\n\n\n\n<p class=\"has-text-align-center has-violet-08-color has-text-color wp-block-paragraph\">We record and post all prior educational webinars to our YouTube channel.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-horizontal is-content-justification-center is-layout-flex wp-container-core-buttons-is-layout-cbcdc57d wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline is-style-outline--2\"><a class=\"wp-block-button__link has-violet-color has-white-background-color has-text-color has-background has-link-color has-border-color wp-element-button\" href=\"https:\/\/youtube.com\/playlist?list=PLKIn9wjqDMOm0DCLhGQN77tnT4MPo_Rcg\" style=\"border-color:#5b47da;border-width:3px;border-radius:100px\" target=\"_blank\" rel=\"noreferrer noopener\">Watch now<\/a><\/div>\n<\/div>\n<\/div><figure class=\"wp-block-media-text__media\" style=\"background-image:url(https:\/\/tiro.expert\/wp-content\/uploads\/2020\/06\/iStock-1203044233-watch-video-1024x683.jpg);background-position:55% 34%\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"683\" src=\"https:\/\/tiro.expert\/wp-content\/uploads\/2020\/06\/iStock-1203044233-watch-video-1024x683.jpg\" alt=\"Focused businessman wear headphones study online watching webinar\" class=\"wp-image-1180 size-full\" srcset=\"https:\/\/tiro.expert\/wp-content\/uploads\/2020\/06\/iStock-1203044233-watch-video-1024x683.jpg 1024w, https:\/\/tiro.expert\/wp-content\/uploads\/2020\/06\/iStock-1203044233-watch-video-300x200.jpg 300w, https:\/\/tiro.expert\/wp-content\/uploads\/2020\/06\/iStock-1203044233-watch-video-768x512.jpg 768w, https:\/\/tiro.expert\/wp-content\/uploads\/2020\/06\/iStock-1203044233-watch-video-1536x1024.jpg 1536w, https:\/\/tiro.expert\/wp-content\/uploads\/2020\/06\/iStock-1203044233-watch-video-scaled.jpg 2048w, https:\/\/tiro.expert\/wp-content\/uploads\/2020\/06\/iStock-1203044233-watch-video-600x400.jpg 600w, https:\/\/tiro.expert\/wp-content\/uploads\/2020\/06\/iStock-1203044233-watch-video-1200x800.jpg 1200w, https:\/\/tiro.expert\/wp-content\/uploads\/2020\/06\/iStock-1203044233-watch-video-1980x1320.jpg 1980w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure><\/div>\n\n\n\n<div class=\"wp-block-group tw-rounded has-blush-light-purple-gradient-background has-background\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<h2 class=\"wp-block-heading\">\u00cates-vous de langue maternelle fran\u00e7aise?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Notre conseil consultatif international a cr\u00e9\u00e9 une version portable de TIRO.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/tiro.expert\/wp-content\/uploads\/2021\/04\/TIRO.expert-Traduction-en-francais-des-recommandations.docx.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><i class=\"fas fa-fw fa-cloud-arrow-down\"><\/i> t\u00e9l\u00e9charger le PDF<\/a><\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<section aria-label=\"Bibliography\" class=\"wp-block-abt-bibliography abt-bibliography\" role=\"region\"><h3 class=\"abt-bibliography__heading\">References<\/h3><ol class=\"abt-bibliography__body\" data-entryspacing=\"1\" data-maxoffset=\"3\" data-linespacing=\"1\" data-second-field-align=\"flush\"><li id=\"1669419985\">  <div class=\"csl-entry\">\n    <div class=\"csl-left-margin\">1. <\/div><div class=\"csl-right-inline\">Haugen B, Alexander E, Bible K, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. <i>Thyroid<\/i>. 2016;26(1):1-133. doi:<a href=\"https:\/\/doi.org\/10.1089\/thy.2015.0020\">10.1089\/thy.2015.0020<\/a><\/div>\n  <\/div>\n<\/li><li id=\"3102056739\">  <div class=\"csl-entry\">\n    <div class=\"csl-left-margin\">2. <\/div><div class=\"csl-right-inline\">Ito Y, Onoda N, Okamoto T. The revised clinical practice guidelines on the management of thyroid tumors by the Japan Associations of Endocrine Surgeons: Core questions and recommendations for treatments of thyroid cancer. <i>Endocr J<\/i>. 2020;67(7):669-717. doi:<a href=\"https:\/\/doi.org\/10.1507\/endocrj.EJ20-0025\">10.1507\/endocrj.EJ20-0025<\/a><\/div>\n  <\/div>\n<\/li><li id=\"1160858975\">  <div class=\"csl-entry\">\n    <div class=\"csl-left-margin\">3. <\/div><div class=\"csl-right-inline\">Haddad RI, Nasr C, Bischoff L, et al. NCCN Guidelines Insights: Thyroid Carcinoma, Version 2.2018. <i>J Natl Compr Canc Netw<\/i>. Published online December 2018:1429-1440. doi:<a href=\"https:\/\/doi.org\/10.6004\/jnccn.2018.0089\">10.6004\/jnccn.2018.0089<\/a><\/div>\n  <\/div>\n<\/li><li id=\"454795586\">  <div class=\"csl-entry\">\n    <div class=\"csl-left-margin\">4. <\/div><div class=\"csl-right-inline\">Filetti S, Durante C, Hartl D, et al. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up\u2020. <i>Ann Oncol<\/i>. 2019;30(12):1856-1883. doi:<a href=\"https:\/\/doi.org\/10.1093\/annonc\/mdz400\">10.1093\/annonc\/mdz400<\/a><\/div>\n  <\/div>\n<\/li><li id=\"1110292741\">  <div class=\"csl-entry\">\n    <div class=\"csl-left-margin\">5. <\/div><div class=\"csl-right-inline\">Shindo ML, Caruana SM, Kandil E, et al. Management of invasive well-differentiated thyroid cancer: An American head and neck society consensus statement: AHNS consensus statement. <i>Head Neck<\/i>. Published online August 2014:n\/a-n\/a. doi:10.1002\/hed.23619<\/div>\n  <\/div>\n<\/li><\/ol><\/section>\n","protected":false},"excerpt":{"rendered":"<p>Recomendaciones de tratamiento 1. Enfermedad metast\u00e1sica refractaria a RAI Enfermedad Metast\u00e1sica Refractaria a RAI ATA \/\/ ESMO \/\/ JAES \/\/ NCCN A. Papel de la Resensibilizaci\u00f3n para la Enfermedad RAIR Comentario de Expertos Existe una gran necesidad no cubierta de opciones de tratamiento \u00f3ptimas para pacientes con DTC refractario a RAI de bajo volumen y crecimiento lento. Existe un inter\u00e9s significativo en el papel potencial de la resensibilizaci\u00f3n en este contexto,...<\/p>","protected":false},"author":1,"featured_media":187,"parent":4458,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"templates\/template-cover.php","meta":{"_acf_changed":false,"inline_featured_image":false,"_uag_custom_page_level_css":"","footnotes":""},"class_list":["post-1405","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO Pro 5.0.5 - aioseo.com -->\n\t<meta name=\"description\" content=\"In patients with advanced disease and where RAI is no longer an option, multikinase inhibitors and cytotoxic therapy might be options in treatment.\" \/>\n\t<meta name=\"robots\" content=\"nosnippet, max-image-preview:large, max-video-preview:-1\" \/>\n\t<meta name=\"google-site-verification\" content=\"dgn_KNbWOqdQMThGOuzuLswqwKwBsjcS82PzbL7RTr4\" \/>\n\t<meta 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