Ari Rosenberg, MD, Yale School of Medicine, New Haven, CT, discusses the results of a randomized Phase II clinical trial evaluating cediranib, an anti-VEGF tyrosine kinase inhibitor (TKI), with or without lenalidomide in iodine 131-refractory differentiated thyroid cancer. Cediranib alone had an objective response rate (ORR) consistent with many other VEGF receptor-targeted therapies in thyroid cancer. However, lenalidomide did not appear to improve response or progression free survival (PFS), compared with cediranib alone in differentiated thyroid cancer. The main findings reinforces the clinical activity of VEGF receptor-targeted TKIs, and that lenalidomide should not be combined with VEGF receptor-targeted therapy. Improved frontline combinations with VEGF receptor-targeted tyrosine kinase inhibitor are required to improve response and PFS. This interview took place at the American Society of Clinical Oncology (ASCO) 2023 Annual Congress in Chicago, IL.

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Eric J. Sherman, MD, and Johannes (Jan) Smit, MD, PhD, discuss the appropriateness of surgery in patients with differentiated thyroid cancer and explain their recommendations for a low iodine diet and hormone therapy following surgery.

Dr. James Lee, MD, Chief of Endocrine Surgery, Co-Director of the Thyroid Center, Columbia University Medical Center.

"Thyroid cancer is actually the fastest growing cancer by number of new cases per year, and it's actually growing faster than even breast cancer in women. The good news is that the primary reason the rate is going up is because we're actually getting better at diagnosing it is because of the widespread use of ultrasound. Ultrasound is a fast, non-radiation based exam that doctors are doing in their offices if they're specialists. Because of the sensitivity of ultrasound, we're actually finding cancers that are much smaller. And so if you look at the graphs, the rate of thyroid cancer diagnoses is increasing, but most of that increase is in the smallest sized group for thyroid cancers."

Thyroid cancer occasionally occurs in pregnant women. This poses a specific challenge for the management of this thyroid cancer. OB/GYN doctors are very good at examining young women’s necks and frequently find lumps in the thyroid gland (thyroid nodules). They often diagnose of papillary thyroid cancer in their women patients and thus thyroid cancer can be diagnosed during a pregnancy. What is important is that these are young, healthy women and in the vast majority of cases have a very curable thyroid cancer. In Dr. Clayman’s practice, he has never performed thyroid surgery on a pregnant woman. The young woman will have an ultrasound when she is diagnosed and have strict measurements taken which will be monitored with ultrasound throughout the pregnancy. Dr. Clayman tells the pregnant young woman with thyroid cancer to enjoy her pregnancy, to eat well, and to breast feed. Once she has fulfilled her commitment to breastfeed her child, then they will proceed with surgery. For more information, see our video on “New Diagnosis of Thyroid Cancer” and you will see that the first rule is to relax. In almost every case you have time to research and make good decisions. Thyroid cancer in a pregnant woman is the same: relax, we almost always have time to cure the cancer after the pregnancy. Do not be in a hurry.

Recurrent thyroid cancer: screening and treatment. [Adv,AYA,H,Ped,PF,SR]
Cord Sturgeon, MD, MS, Endocrine Surgeon
Originally presented by @ThyCaInc at the 25th International Thyroid Cancer Survivors' Virtual Conference held in September of 2022.