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Drug Treatment of Thyroid Cancer

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Dear Colleagues,

Thyroid cancer (TC), the most common endocrine malignancy, has become a relevant public health problem. Tumors derived from follicular cells constitute a majority of the thyroid neoplasms. Conventional treatment includes surgery, radioactive iodine therapy, and the suppression of thyroid hormones and has shown its effectiveness in most cases. However, there is currently a notable therapeutic challenge for more aggressive cases with recurrent or advanced local metastatic disease or I131-refractory thyroid cancers. Research related to treatment has progressed, including immunotherapies and precision medicine, and new molecules have come into practice, targeting specific genetic changes with a positive effect on survival rates in aggressive and refractory cases.

The aim of the present collection is to identify new aspects of current treatment in order to improve thyroid cancer management. Within this research topic, we encourage the submission of manuscripts related to new perspectives in the targeted treatment.

This research topic includes, but is not limited to, the following:

New treatments for advanced thyroid cancer and potential mechanisms of drug resistance;
Genetics and epigenetics in relation to thyroid cancer treatment;
New aspects of first-line tyrosine kinase inhibitor treatment and salvage therapy in differentiated thyroid cancer (DTC);
Novelties in combined therapy with inhibitors of different signaling pathways activated in DTC to overcome the resistance to a single tyrosine kinase inhibitor or targeted therapy;
Redifferentiation treatment in thyroid cancer refractory to radioactive iodine—new tracks and results;
Innovative approaches targeting genetic aberrations for therapeutic interventions;
Immunotherapy in thyroid cancer—new findings;
Importance of thyroid tumor microenvironment and its effect on tumor progression and drug resistance;
New therapies in other histological types of thyroid cancer.

Dr. Cristina Alina Silaghi
Prof. Dr. Carmen Emanuela Georgescu
Dr. Horaţiu Silaghi
Dr. Cristina Pop
Guest Editors

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10 pages, 720 KiB

Open AccessArticle

Low-Dose Versus Standard-Dose Radioiodine Therapy in Differentiated Thyroid Cancer: Focus on Tolerability in a Retrospective Evaluation

by Laura Musso, Cristina Maltese, Giulio Beretta, Ilaria Patelli, Stefano Raffa, Arnoldo Piccardo, Francesco Fiz, Lara Vera, Manuela Albertelli, Michele Minuto, Diego Ferone, Marcello Bagnasco and Stefano Gay

Pharmaceuticals 2025, 18(4), 443; https://doi.org/10.3390/ph18040443 - 21 Mar 2025

Viewed by 323

Abstract

Background: The role of radioiodine (RAI) therapy for differentiated thyroid cancers (DTCs) is still a matter of debate. Low-dose RAI (LDRAI) therapy is a possible treatment for patients at low–intermediate risk of recurrence. The aim of this study was to evaluate the occurrence of post-RAI therapy clinical and biochemical side effects with respect to its dosage. Methods: We retrospectively examined 142 patients who had been administered RAI therapy for DTCs and carried out at least a 12-month follow-up. The incidence of clinical adverse events (CAEs: xerophthalmia, xerostomia, and dysgeusia) and values for hemoglobin (Hb), red blood cells (RBCs), white blood cells (WBCs) and platelets (PLTs) during the first year of follow-up were compared between patients who underwent standard-dose RAI (SDRAI) therapy and LDRAI therapy. Results: Of the 142 patients, 66 were treated with LDRAI and 76 with SDRAI. A higher incidence of CAEs was found in the SDRAI group than in the LDRAI group (p = 0.002). An administered dose above 2849 MBq was associated with CAEs (sensitivity 88.89%, specificity 54.03%, p < 0.001). We found a slight decrease in Hb (p = 0.008), RBCs (p = 0.013), WBCs (p = 0.004) and PLTs (p < 0.001) in the SDRAI group, while in the LDRAI group only WBCs showed a minimal decrease (p = 0.027) with any occurrence of overt bone-marrow disease. Conclusions: According to our data, LDRAI therapy seemed to be associated with a lower incidence of CAEs than SDRAI therapy. Both methods showed an excellent safety profile in terms of hematopoietic effects. However, the effect of SDRAI therapy in this setting might have been more positive than that of LDRAI therapy. Full article

(This article belongs to the Special Issue Drug Treatment of Thyroid Cancer)

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