Latest Treatments and Research at MSK To Treat Thyroid Cancer in 2025 

Thyroid cancer is the most common form of cancer found in the head and neck area and is diagnosed in more than 44,000 people in the United States every year. 

There are many different types of thyroid cancer. Some, such as early-stage papillary cancers, grow slowly and are easy to treat — or may not need treatment at all. Other kinds of thyroid cancers, such as nonanaplastic thyroid carcinomas, can be more aggressive and require sophisticated molecular testing to determine the best treatment.  

Many patients have no symptoms of thyroid cancer, or they can vary widely, including:  

• A swollen throat nodule or lump
• Hoarseness 
• Trouble breathing  

Doctors at Memorial Sloan Kettering Cancer Center (MSK) offer the latest treatments for thyroid cancer and are leading new clinical trials and research to improve the prognosis for the most aggressive thyroid cancers, while avoiding unnecessary treatments for the low-risk type.  

Here is how MSK is advancing new treatments for thyroid cancer. 

Increasing Evidence for Active Surveillance for Low-Risk, Early-Stage Papillary Thyroid Cancer  

The number of people diagnosed annually with low-risk thyroid cancer has tripled in the past 30 years, though deaths from thyroid cancer did not increase during the same period, according to the National Cancer Institute. Scientists attribute the dramatic rise in papillary thyroid cancer cases to the increased use of CT scans, which can detect small tumors unlikely to grow and become dangerous. Doctors want to avoid overtreating early papillary thyroid cancers and spare patients from the side effects of potentially unnecessary therapies like medication and surgery.  

For people with small tumors that don’t appear to be aggressive, there is growing evidence to support “active surveillance” or “watchful waiting,” which means closely monitoring patients through ultrasounds and office visits. Since MSK’s active surveillance program was launched in 2012, studies have shown that for the vast majority of patients, their thyroid tumors never grow, and they won’t need treatment.  

Among the 10% to 20% of patients whose papillary thyroid tumors do grow during active surveillance, it is still possible to successfully treat the cancer with surgery and other therapies, according to a recent study, led by MSK Endocrinology Service Chief R. Michael Tuttle, MD, and published in JAMA Otolaryngology – Head & Neck Surgery. It found the outcomes were just as good as they were for those treated at the time of diagnosis.  

“These findings provide additional support to the idea that, for patients with low-risk papillary thyroid cancer, participating in an active surveillance program does not lead to worse outcomes,” Dr. Tuttle says. “Those who later require surgery because their tumors progress still have excellent survival and low recurrence rates.”  

Learn more about MSK’s active surveillance program for low-risk papillary thyroid cancer. 

Using Genetic Data To Improve Treatment of Nonanaplastic Thyroid Carcinomas, Like HGFCTC  

Nonanaplastic thyroid carcinoma is more likely to grow and spread than papillary thyroid cancer but is not as serious as some other types. Nonanaplastic thyroid carcinomas are usually treated with surgery and radioactive iodine.  

Now, new research from MSK is improving the treatment of the more aggressive types of nonanaplastic thyroid cancer, known as high-grade follicular cell-derived nonanaplastic thyroid carcinoma (HGFCTC). There are five different subtypes of HGFCTC that are diagnosed based on a tumor’s size and location and how the cancer cells look under the microscope.    

For patients with HGFCTC, molecular analysis with a tumor test like MSK-IMPACT^® can give doctors genetic information to help them identify which patients need more intense treatment. MSK-IMPACT detects more than 500 gene mutations that have been linked to cancer.  

In a recent study published in Thyroid and led by MSK head and neck surgeon Ian Ganly, MD, PhD, researchers found that certain gene mutations are associated with different subtypes of HGFCTC. In some cases, these gene mutations could suggest which treatments are most likely to be effective, including targeted drugs for those specific mutations.  

“We think information about the genetic mutations found in a tumor should be regularly incorporated into the diagnosis of HGFCTC,” Dr. Ganly says.  

Improving Radioactive Iodine Treatments for Thyroid Cancer With Targeted Therapy  

One of the most commonly used medications for thyroid cancer is radioactive iodine (RAI). It is taken orally as a pill or liquid, then spreads throughout the body. The treatment is selectively taken up by thyroid cancer cells, delivering a strong dose of radiation directly to tumors and sparing healthy tissues.  

The benefit of RAI is that it reaches cancer cells that may be left behind after surgery. It is also used to treat cancer that has metastasized (spread) to other parts of the body. Unfortunately, about two-thirds of people with metastatic thyroid cancer eventually become resistant to RAI: Their cancer cells no longer take up the iodine.  

But MSK research, begun more than a decade ago by MSK’s head and neck medical oncologist Alan Ho, MD, PhD, discovered that in almost half of patients who have stopped responding to RAI, a targeted therapy called selumetinib (Koselugo^®) can alter cancer thyroid tumor cells so they can again take up the iodine. Since that paradigm-shifting study, subsequent trials continued to demonstrate that personalizing targeted therapies based on a handful of key cancer mutations can restore RAI uptake and efficacy in some patients. 

Dr. Ho and his colleagues continue to study this novel treatment, termed “redifferentiation,” to address key outstanding questions, such as how to identify patients who will benefit, as well as analyzing both the short- and long-term risks and benefits of this strategy.  

As one of the leaders of the International Thyroid Oncology Group, Dr. Ho recently led a review of the latest evidence, which also included MSK endocrinologist Laura Boucai, MD, and endocrinologist James Fagin, MD, Head of the Division of Subspecialty Medicine. Their statement was published in The Lancet Diabetes and Endocrinology.  

“It’s important that future trials look at the timing of this treatment and the best way to give it,” says Dr. Ho, Chief of the Head and Neck Oncology Service at MSK. “We also need to continue to study how it impacts patient survival.”  

Using Larotrectinib Earlier To Treat NTRK-Positive Thyroid Cancers  

Some thyroid cancers are caused by changes to the NTRK gene and can be treated with the targeted drug larotrectinib (Vitrakvi^®), which is approved by the U.S. Food and Drug Administration (FDA) for adults and children whose cancer has not responded to other therapies. Larotrectinib was developed under the leadership of MSK thoracic medical oncologist and early drug development specialist Alexander Drilon, MD.  

Clinical trials have shown that larotrectinib helps NTRK thyroid cancer patients live longer, has few side effects, and is effective in treating several tumor types, in addition to thyroid cancer.  

Now a new study has found that using larotrectinib as a first-line treatment (for patients who have not yet received other drug treatments) also benefits those who have an NTRK-positive cancer. The clinical trial, published recently in ESMO OPEN, was led by Dr. Drilon.  

The first-line larotrectinib clinical trial results were excellent. In the patients with thyroid cancer, nearly 90% of the tumors shrank significantly, and about 3 out of 4 patients were alive after five years.  

“Not only did patients with NTRK-fusion cancers benefit from larotrectinib earlier in their treatment,” Dr. Drilon says, “but by offering it sooner, we allowed many of them to avoid the more serious side effects of treatments like chemotherapy.”  

MSK Has Clinical Trials Currently Enrolling Patients With Thyroid Cancer  

MSK is continuing to lead research to develop new approaches and therapies for people with thyroid cancer.  

See a list of open thyroid cancer clinical trials.