Sistema de Salut de Catalunya
Institut Català de la Salut
[Ryška A] The Fingerland Department of Pathology, Charles University, Faculty of Medicine, Hradec Kralove, Czechia. University Hospital, Hradec Kralove, Czechia. [Capdevila J] Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Dettmer MS] Klinikum Stuttgart, Institute of Pathology, Stuttgart, Baden-Württemberg, Germany. Institute of Tissue Medicine and Pathology, University of Bern, Bern, Switzerland. [Elisei R] Endocrine Unit, University Hospital of Pisa, Pisa, Italy. [Führer D] Department of Endocrinology, Diabetes and Metabolism, Endocrine Tumour Centre at West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. [Hadoux J] Service d’oncologie endocrinienne, département d’imagerie & ENDOCAN-TUTHYREF Network, Gustave Roussy, Villejuif, France
Vall d'Hebron Barcelona Hospital Campus
2025-08-07T06:54:29Z
2025-08-07T06:54:29Z
2025-08
Biomarkers; Molecular testing; Thyroid cancer
Biomarcadores; Pruebas moleculares; Cáncer de tiroides
Biomarcadors; Proves moleculars; Càncer de tiroides
As new precision oncology therapies become available in the thyroid cancer (TC) treatment landscape, appropriate and timely biomarker testing is crucial for treatment selection and requires a multidisciplinary approach. Recently published European guidelines on advanced/metastatic TC management include a special focus on biomarker testing. However, to date, there remains a need for comprehensive European guidance for standardized molecular testing strategies in TC that encompass a broad set of targetable or potentially targetable alterations, timing of testing, and patients to be tested. This expert opinion article outlines consensus testing algorithms for differentiated TC, medullary TC, and anaplastic TC from a team of endocrinologists, oncologists, molecular biologists, and pathologists to provide standardized recommendations for physicians involved in treating patients with advanced TC. In the differentiated TC algorithm, patients recommended for comprehensive testing by DNA and RNA next-generation sequencing (NGS) include those whose disease has progressed on or is resistant to radioactive iodine treatment. The medullary TC algorithm recommends RET germline testing for all patients at diagnosis. For patients exhibiting high-risk clinical or pathological features and those whose disease progresses, somatic RET testing with NGS should be discussed and conducted before considering systemic treatment. As anaplastic TC is a highly aggressive disease, molecular reflex testing for BRAF mutations is recommended for all patients at diagnosis, followed by DNA and RNA NGS for those who test BRAF negative. The article also provides consensus recommendations on the use of tumor tissue for testing and on centralization of molecular testing involving multidisciplinary tumor boards.
Funding for the development of this manuscript was provided by Eli Lilly and Company.
Article
Published version
English
Tiroide - Càncer - Diagnòstic; Marcadors tumorals; Decisió, Presa de; CHEMICALS AND DRUGS::Biological Factors::Biomarkers::Biomarkers, Tumor; DISEASES::Neoplasms::Neoplasms by Site::Endocrine Gland Neoplasms::Thyroid Neoplasms; Other subheadings::Other subheadings::/diagnosis; PSYCHIATRY AND PSYCHOLOGY::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus; COMPUESTOS QUÍMICOS Y DROGAS::factores biológicos::biomarcadores::marcadores tumorales; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias de las glándulas endocrinas::neoplasias de la tiroides; Otros calificadores::Otros calificadores::/diagnóstico; PSIQUIATRÍA Y PSICOLOGÍA::conducta y mecanismos de la conducta::psicología social::procesos de grupo::consenso
Bioscientifica
European Thyroid Journal;14(4)
https://doi.org/10.1530/ETJ-25-0024
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
