NCCN Guidelines for Patients
Thyroid Cancer, Version 1.2017
Chemotherapy is usually given to people with
anaplastic thyroid cancer, but is used for other types
of cancers only in very rare cases. For anaplastic
thyroid cancer, chemotherapy drugs like paclitaxel
or doxorubicin may be given alone. Combinations
of chemotherapy drugs for anaplastic thyroid cancer
may include paclitaxel and carboplatin, or docetaxel
When chemotherapy is combined with radiation
treatment it is called chemoradiation. It is usually
not used to treat other types of thyroid cancer.
Chemotherapy may also be used to treat thyroid
cancer that is not responding to other treatment.
Since it is systemic, it may be used to treat cancer
that has spread to distant areas of the body.
A side effect is when the cancer treatment harms
the healthy tissue in your body. Chemotherapy
drugs attack fast-dividing cancer cells and can also
damage normal cells that are dividing rapidly. Some
people have many side effects, while others have
a few or even none at all. Some side effects can
be very serious while others can be hard to cope
with, but not serious. Most side effects appear when
treatment starts and stop when treatment is over.
Common side effects of chemotherapy may include:
Extreme tiredness (fatigue)
Nausea and vomiting
Not wanting to eat
Low blood cell counts
Not all side effects of chemotherapy are listed here.
Side effects are usually grouped by whether they
are more or less likely to occur. Some effects can
be long-term or appear years later like another
cancer, heart disease, or not being able to have
children (infertility). It is helpful to ask your doctor for
a complete list of side effects. Learn how you can
prevent and cope with possible side effects.
Targeted therapies are drugs that sometimes can
directly kill cancer cells. They may also affect the
chemical signals between different cells and stop
their growth. This treatment is somewhat less likely
to harm normal cells than chemotherapy. Targeted
therapies can be used alone as a single agent or
combined with other drugs. People with thyroid
cancers that have recurred or are metastatic, and
cannot be treated by surgery alone may be given
Kinase inhibitors are a type of targeted therapy.
Some of these targeted therapies have proven
to be helpful in treating or controlling the growth
of thyroid cancer. Kinase inhibitors (ie, lenvatinib,
sorafenib) may be given to treat thyroid cancer that
does not respond to other treatment like RAI therapy.
If RAI therapy is not an option and other systemic
treatment or clinical trials are not an option, other
kinase inhibitors may be considered for differentiated
thyroid cancer that is metastatic and/or causing
symptoms. This includes kinase inhibitors such
as axitinib, everolimus, pazopanib, sunitinib,
vandetanib, vemurafenib (BRAF-positive disease), or
For medullary thyroid cancer not responding
(progressing) on vandetanib or cabozantinib, or when
these drugs or a clinical trial are not an option, other
kinase inhibitors may be considered. These include
sorafenib, sunitinib, lenvatinib, or pazopanib.