Advanced metastatic radioiodine refractory differentiated thyroid cancer: current treatment and dynamic surveillance issues

The patients with progressive metastatic radioiodine refractory differentiated thyroid cancer have a rather unfavorable prognosis. Their life expectancy, according to various authors, does not exceed 3–5 years. To date, tyrosine kinase inhibitors have demonstrated their effectiveness in the treatment of such patients, and in particular, lenvatinib, which is recommended by all leading world communities as the first line of targeted therapy for such patients. The undoubted benefit of targeted therapy with lenvatinib is associated with the development of a fairly large number of adverse events and, accordingly, a decrease in the quality of life of patients. To date, most experts have come to the unambiguous conclusion that there is no need to rush to prescribe targeted therapy without real need. Unfortunately, despite the huge number of different schools and conferences devoted to this topic, most specialists have quite limited experience in the treatment and dynamic observation of patients with progressive radioiodine refractory differentiated thyroid cancer.In this article, using a clinical example, we will try to shed light on the difficulties encountered in the treatment of patients with progressive metastatic radiodefractive differentiated thyroid cancer.