Targeted therapy for thyroid cancer

Thyroid Cancer Treatment: How Chemotherapy Use is Evolving

Reese Marlowe in Health & Wellness December 2025 • 4 min read.

"Discover the latest trends in chemotherapy for thyroid cancer, including the role of multikinase inhibitors (MKIs) and factors influencing treatment decisions."

Thyroid cancer is on the rise, with over 64,000 people diagnosed each year. While most cases are highly treatable, some differentiated thyroid cancers (DTCs) and medullary thyroid cancers (MTCs) don't respond to standard therapies, leading to poorer outcomes. For these challenging cases, chemotherapy, including newer targeted drugs, may be considered.

Multikinase inhibitors (MKIs) emerged as a new treatment option, gaining FDA approval for MTC in 2011 and metastatic DTC in 2013. These drugs offer hope for slowing disease progression, but how have they impacted the overall use of chemotherapy in thyroid cancer treatment?

To understand the changing landscape, researchers analyzed data from the National Cancer Database (NCDB) between 2004 and 2013. The goal was to identify trends in chemotherapy use, including MKIs, among patients with DTC and MTC.

Key Findings: Chemotherapy Use and Its Predictors

The study included nearly 200,000 patients, providing a comprehensive look at treatment patterns. The analysis revealed significant insights into chemotherapy use based on cancer type, stage, and other factors.

Here's a breakdown of the key findings:

MTC Treatment Shifts: Chemotherapy use in MTC increased from 3.1% (2004-2010) to 5.0% (2011-2013) following MKI approval. This increase was statistically significant, suggesting MKIs are influencing treatment decisions.
Metastatic DTC Trends: Chemotherapy use in metastatic DTC was low, with 4.9% of patients receiving it in 2013. This rate was not significantly higher than in previous years, indicating limited MKI adoption in this group.
Factors Influencing Chemotherapy: For MTC, metastatic disease, regional lymph node spread, and larger tumor size were associated with increased chemotherapy use. Patient demographics like gender and insurance type did not significantly impact the decision after adjusting for other factors.
Facility Type: Facility type (community vs. teaching/research center) didn't significantly affect chemotherapy use, suggesting treatment decisions are consistent across different care settings.

While MKIs have made an impact, chemotherapy use remains relatively low overall, particularly for metastatic DTC. This highlights the need for further research to optimize treatment strategies and identify patients who would benefit most from these therapies.

Implications and Future Directions

This study provides valuable insights into the evolving landscape of thyroid cancer treatment. The modest increase in chemotherapy use for MTC following MKI approval suggests these drugs are gradually being integrated into practice.

However, the low uptake of chemotherapy for metastatic DTC warrants further investigation. Factors such as treatment costs, limited effectiveness, and physician preferences may be contributing to this trend.

Future research should focus on identifying predictive biomarkers to guide treatment decisions and optimize the use of MKIs and other chemotherapeutic agents in thyroid cancer. Continuous monitoring of treatment patterns is also crucial to assess the long-term impact of new drugs and ensure equitable access to effective therapies.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1159/000449379, Alternate LINK

Title: Trends And Predictors Of Chemotherapy Use Among Thyroid Cancer Patients In The National Cancer Database (2004-2013)

Subject: Endocrinology, Diabetes and Metabolism

Journal: European Thyroid Journal

Publisher: Bioscientifica

Authors: Stacey A. Fedewa, Ahmedin Jemal, Amy Y. Chen

Published: 2016-01-01

Everything You Need To Know

What are multikinase inhibitors (MKIs), and how do they work in treating thyroid cancer?

Multikinase inhibitors, or MKIs, are a class of drugs that have gained FDA approval for medullary thyroid cancer in 2011 and metastatic differentiated thyroid cancer in 2013. They work by targeting multiple kinases, which are enzymes involved in cell growth and proliferation. By inhibiting these kinases, MKIs can help slow down the progression of thyroid cancer. While MKIs represent a significant advancement, they are not a one-size-fits-all solution and their impact on overall chemotherapy use varies depending on the specific type and stage of thyroid cancer. The adoption of MKIs also depends on factors like disease progression and patient characteristics. Further research is necessary to determine the optimal use of MKIs and to identify patients who would benefit most from these targeted therapies.

How has the use of chemotherapy changed in medullary thyroid cancer (MTC) and metastatic differentiated thyroid cancer (DTC) since the introduction of multikinase inhibitors (MKIs)?

The analysis of the National Cancer Database (NCDB) data from 2004 to 2013 reveals that chemotherapy use in medullary thyroid cancer (MTC) increased from 3.1% (2004-2010) to 5.0% (2011-2013) following the FDA approval of multikinase inhibitors (MKIs). This statistically significant rise suggests that MKIs are influencing treatment decisions for MTC. However, chemotherapy use in metastatic differentiated thyroid cancer (DTC) remained low, with only 4.9% of patients receiving it in 2013, showing limited MKI adoption in treating metastatic DTC.

What factors influence the decision to use chemotherapy, including multikinase inhibitors (MKIs), in thyroid cancer treatment?

Several factors influence the decision to use chemotherapy in thyroid cancer treatment. For medullary thyroid cancer (MTC), the presence of metastatic disease, regional lymph node spread, and larger tumor size are associated with increased chemotherapy use. Facility type (community vs. teaching/research center) did not significantly affect chemotherapy use, suggesting treatment decisions are consistent across different care settings. Patient demographics such as gender and insurance type did not significantly impact the decision after adjusting for other factors.

Why is the use of chemotherapy, including multikinase inhibitors (MKIs), still relatively low for metastatic differentiated thyroid cancer (DTC), and what does this imply?

While multikinase inhibitors (MKIs) have shown promise in treating thyroid cancer, particularly medullary thyroid cancer (MTC), their impact on metastatic differentiated thyroid cancer (DTC) has been more limited. The analysis of the National Cancer Database (NCDB) data reveals that chemotherapy use in metastatic DTC remains relatively low, even after the introduction of MKIs. This suggests that further research is needed to identify which patients with metastatic DTC would benefit most from MKIs and to optimize treatment strategies for this subgroup of patients. Clinical trials may be necessary to evaluate the efficacy of MKIs in combination with other therapies or in specific patient populations.

What are the future directions for research and treatment strategies in thyroid cancer, considering the evolving role of multikinase inhibitors (MKIs)?

The insights from analyzing the National Cancer Database (NCDB) data suggest a gradual integration of multikinase inhibitors (MKIs) into the treatment paradigm for medullary thyroid cancer (MTC). However, the relatively low use of chemotherapy, including MKIs, for metastatic differentiated thyroid cancer (DTC) highlights the need for ongoing research to refine treatment strategies. Future studies could explore biomarkers to predict treatment response, evaluate novel combinations of therapies, and personalize treatment decisions based on individual patient and tumor characteristics. Understanding the long-term outcomes and potential side effects of MKIs is also crucial for optimizing their use in thyroid cancer treatment.