[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-365463-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-365463-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","systemic-therapies-for-medullary-thyroid-carcinoma-state-of-the-art","Systemic therapies for medullary thyroid carcinoma: state of the art","","Medullary thyroid carcinoma (MTC) is a rare neuroendocrine malignancy representing less than 5% of thyroid cancers. Approximately 25% of cases are familial due to germline RET mutations, while sporadic tumors carry RET mutations in about 40%–60%. RET genotype influences clinical behavior, with the M918T variant linked to aggressive disease. For progressive metastatic MTC, systemic therapy relies on multikinase inhibitors (cabozantinib, vandetanib) and high-specific RET inhibitors. Timing of initiation should be individualized through multidisciplinary evaluation of performance status, tumor burden, progression rate, comorbidities, drug interactions, and goals of care.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/systemic-therapies-for-medullary-thyroid-carcinoma-state-of-the-art/365463/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/systemic-therapies-for-medullary-thyroid-carcinoma-state-of-the-art/365463.png","ImageObject",300,407,{"name":42,"@type":43},"Kyle","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",12,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What genetic factor is central to medullary thyroid carcinoma, and how does it affect disease behavior?","Question",{"text":63,"@type":64},"RET mutations play a key role in both familial and sporadic MTC. The RET M918T variant is associated with more aggressive disease behavior.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What systemic treatment options are commonly used for progressive metastatic MTC?",{"text":68,"@type":64},"Treatment typically includes multikinase inhibitors such as cabozantinib and vandetanib, along with high-specific RET inhibitor therapy targeting RET activity.",{"name":70,"@type":61,"acceptedAnswer":71},"How should clinicians decide when to start systemic therapy in patients with advanced MTC?",{"text":72,"@type":64},"Initiation timing should be individualized in a patient-centered, multidisciplinary approach, considering performance status, tumor burden, progression rate, comorbidities, potential drug interactions, and patient goals of care.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},365463,1790727948,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":146},3985741905716,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","TherapeuTic advances in  \nendocrinology andMetabolism Review  \nSystemic therapies for medullary thyroid carcinoma: state of the art  \nAlejandro Román-González, Ines Califano, Marcio Concepción-Zavaleta, Fabian Pitoia and Sarimar Agosto Salgado  \nAbstract: Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor accounting for less than 5% of all thyroid cancers. An estimated 25% of cases are familial secondary to a germline mutation on the rearranged during transfection proto-oncogene (RET); this gene can be present as a somatic mutation in approximately 40%–60% of sporadic MTC tumors. There is an existing genotype-phenotype correlation in the clinical behavior of MTC, with the RET M918T variant associated with aggressive disease. The current systemic treatment profile for progressive metastatic MTC involves antiangiogenics multikinase inhibitors (MKI), specifically cabozantinib and vandetanib, and high-specific RET inhibitor therapy. Decisions on the timing of systemic therapy initiation in this population should involve multidisciplinary care and individualization on a case-by-case scenario; a comprehensive evaluation of performance status, tumor burden, progression rate, medical comorbidities, possible medication interactions, and goals of care must be considered ina patient-centered approach. This review summarizes the evidence on the safety, efficacy, and limitations of systemic therapies for MTC; the aim is to empower clinicians with the knowledge to optimally manage patients with advanced, progressive, or metastatic MTC.  \nPlain language summary  \nTreatment options for metastatic medullary thyroid carcinoma  \nMedullary Thyroid Carcinoma (MTC) is a rare type of thyroid cancer, making up less than 5% of all cases. Some people inherit this condition due to a mutation in a specific gene called RET, while others develop it sporadically, with this gene being mutated in about 40-60% of these cases. The behavior of the disease can vary, and certain genetic changes, like the RETM918T variant, are linked to more aggressive forms of MTC. When MTC becomes advanced or spreads, treatment usually involves special drugs called multikinase inhibitors (MKI), like cabozantinib and vandetanib, which target the cancer’s growth pathways. There’s also a treatment specifically designed to block the RET gene’s activity. Deciding when to start these treatments isn’t straightforward. It requires a careful evaluation of each patient’s overall health, how much the cancer has spread, how quickly it’s progressing, other medical conditions, potential drug interactions, and the patient’s personal treatment goals. This decision-making process is best handled by a team of specialists who can tailor the approach to each individual’s needs. This summary provides an overview of the current treatments for MTC, focusing on their safety, effectiveness, and limitations, with the goal of helping doctors make informed decisions for managing patients with advanced stages of this disease.  \nKeywords: cabozantinib, calcitonin, medullary thyroid carcinoma, selpercatinib, vandetanib  \nReceived: 29 September 2024; revised manuscript accepted: 1 April 2025.  \nTherAdv Endocrinol Metab  \n2025, Vol. 16: 1–18  \nDOI: 10. 1177/ 20420188251336091 © The Author(s), 2025.  \nArticle reuse guidelines: [sagepub.com/journals](sagepub.com/journals)permissions  \nCorrespondence to:  \nAlejandro RománGonzález  \nSection of Endocrinology, Department of Internal Medicine, School of  \nMedicine, Universidad de Antioquia,(University of Antioquia), Cra. 51d No. 62-29, Medellín 050001, Colombia  \nalejandro.roman@udea. [edu.co](edu.co)  \nInes Califano  \nEndocrinology Service, Instituto de Oncología“Angel H. Roffo”(Angel H. Roffo Institute of Oncology), University of Buenos Aires, Buenos Aires, Argentina  \nMarcio ConcepciónZavaleta  \nCarrrera de Medicina Humana Universidad Científica del Sur (Scientific University of the South), Lima, Peru  \nFabian Pitoia  \nDivision of Endocrinology, Hospit","cbCaivNJcrgNEwiM","https://ap.wps.com/l/cbCaivNJcrgNEwiM","pdf",813531,18,"English","# Abstract\n# Plain language summary\n# Keywords\n# Introduction\n## Disease background and genetics\n## Clinical presentation","[{\"question\":\"What genetic factor is central to medullary thyroid carcinoma, and how does it affect disease behavior?\",\"answer\":\"RET mutations play a key role in both familial and sporadic MTC. The RET M918T variant is associated with more aggressive disease behavior.\"},{\"question\":\"What systemic treatment options are commonly used for progressive metastatic MTC?\",\"answer\":\"Treatment typically includes multikinase inhibitors such as cabozantinib and vandetanib, along with high-specific RET inhibitor therapy targeting RET activity.\"},{\"question\":\"How should clinicians decide when to start systemic therapy in patients with advanced MTC?\",\"answer\":\"Initiation timing should be individualized in a patient-centered, multidisciplinary approach, considering performance status, tumor burden, progression rate, comorbidities, potential drug interactions, and patient goals of care.\"}]","Systemic therapies for medullary thyroid carcinoma: state of the art | PDF",1790160999,45]