Contemporary systemic therapy of medullary thyroid cancer

INTRODUCTION: Medullary thyroid cancer (MTC) is a less common subtype of thyroid cancer, and it should be managed under the care of expert multidisciplinary teams. AREAS COVERED: Based on the available literature, the role of systemic therapy for MTC has evolved over the past couple of decades in line with the rapid development in our understanding of the biology of this cancer. Despite the initial successes of selective RET inhibitors in achieving good responses and reasonable disease control, resistance eventually develops in most patients. EXPERT OPINION: There is an unmet need to develop newer therapeutic approaches for the management of MTC. This should happen through multicenter, international collaborative efforts given the rarity of this cancer.