关键词: 甲状腺癌, 远处转移, 靶向治疗, 免疫治疗

Abstract: Treatment strategies for distant metastatic thyroid cancer in the era of target and immune therapy        CHEN Jia-ying, WANG Yu. Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Corresponding author: WANG Yu, E-mail：Neck130@hotmail.com
Abstract    Thyroid cancer is the most common endocrine tumor. Patients with advanced thyroid cancer cannot be cured by surgery, are refractory to iodine treatment, and are insensitive to radiotherapy and chemotherapy. The prognosis of patients is poor with ineffective therapies, and most of the annual deaths are among these patients. The in-depth understanding of tumor molecular biology and the discovery of driver genes have led to the rapid development of precision treatment of distant metastatic thyroid cancer. Driver genes are the fundamental driving factors for the occurrence and development of thyroid cancer. The discovery of gene mutations such as BRAF, TERT, and RET fusions for guides efficient and precise treatment of patients with advanced DTC, PTDC, MTC, and ATC. At the same time, related targeted and immune drugs are also booming, and the treatment of advanced thyroid cancer has entered the era of targeted therapy. Currently, multiple multi-target tyrosine kinase inhibitors and highly selective inhibitors are approved for the treatment of advanced and metastatic thyroid cancer. Treatment with PD-1/L1 inhibitors is also being explored in specific pathological types of thyroid cancer.  In clinical practice, it is necessary to rationally select medication practices and strategies based on the patient's disease development, pathology, and molecular characteristics to improve advanced patients' survival rate and quality of life.

Key words: thyroid cancer, distant metastasis, target therapy, immunotherapy