Precision Thyroid Oncology Using Genetic-Based Therapies: A Narrative Review
Vincenzo Marotta, Mingzhao Xing, Mario VitaleBackground:
Most thyroid malignancies harbor a limited set of well-characterized mutations driving tumor initiation and determining phenotype. This relatively direct genotype–phenotype association, bringing insights into molecular mechanisms of progression and drug resistance, makes advanced thyroid cancers suitable for genetic-based therapies. Personalized cancer treatment by targeting actionable tumor mutations represents one of the most innovative frontiers in oncology.
Summary:
The present narrative review focuses on actionable mutations occurring in thyroid cancers and provides a state-of-the-art overview of genetic-based treatments that have received regulatory approval worldwide. These include two selective RET inhibitors (sRET-Is) (selpercatinib and pralsetinib), three NTRK inhibitors (NTRK-Is) (larotrectinib, entrectinib, and repotrectinib), and two dual BRAF/MEK inhibitor regimens (dabrafenib plus trametinib and encorafenib plus binimetinib). The most significant impact has been observed in the management of
Conclusions:
Precision oncology is increasingly being integrated into the management of advanced thyroid cancer. However, its impact varies widely across different tumor settings, and its real-world use is strongly influenced by country-specific drug regulations.