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NCCN Guidelines for Patients



Thyroid Cancer, Version 1.2017


Cancer treatment

Targeted therapy

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

and doxorubicin.

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









Hair loss



Mouth sores



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 therapy

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

targeted therapy.

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.