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Elisa Minaldi Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Virginia Cappagli Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Loredana Lorusso Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Laura Valerio Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Carlotta Giani Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Matilde Viglione Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Laura Agate Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Eleonora Molinaro Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Antonio Matrone Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Rossella Elisei Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Introduction Thanks to the results of DECISION and SELECT trials, sorafenib and lenvatinib are the only MKIs approved by both the U.S. Food and Drug Administration (FDA) and the European Medical Agency (EMA) for the first-line treatment of

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Xian Qiu Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China

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Lin Cheng Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China

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Ri Sa Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
Department of Nuclear Medicine, The First Hospital of Jilin University, Changchun, China

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Hao Fu Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
Department of Nuclear Medicine & Minnan PET Center, The First Affiliated Hospital of Xiamen University, Xiamen, China

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Yuchen Jin Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

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Libo Chen Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China

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, including chemotherapy and external beam radiation therapy, remains limited in these challenging settings. In recent years, tyrosine kinase inhibitors (TKIs) such as sorafenib and lenvatinib have highlighted new therapeutic options for the treatment of

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Haruhiko Yamazaki Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama City, Kanagawa, Japan
Department of Surgery, Ito Hospital, Shibuya-ku, Tokyo, Japan

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Kiminori Sugino Department of Surgery, Ito Hospital, Shibuya-ku, Tokyo, Japan

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Ryohei Katoh Department of Pathology, Ito Hospital, Shibuya-ku, Tokyo, Japan

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Kenichi Matsuzu Department of Surgery, Ito Hospital, Shibuya-ku, Tokyo, Japan

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Wataru Kitagawa Department of Surgery, Ito Hospital, Shibuya-ku, Tokyo, Japan

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Mitsuji Nagahama Department of Surgery, Ito Hospital, Shibuya-ku, Tokyo, Japan

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Aya Saito Department of Surgery, Yokohama City University School of Medicine, Yokohama City, Kanagawa, Japan

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Koichi Ito Department of Surgery, Ito Hospital, Shibuya-ku, Tokyo, Japan

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RAI. However, some FTCs become refractory to RAI. Multi-tyrosine kinase inhibitors such as sorafenib and lenvatinib are utilized for treating RAI-refractory FTCs ( 8 , 9 ). Numerous guidelines regarding differentiated thyroid carcinoma have been

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Daniela Dias Endocrinology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal

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Inês Damásio Endocrinology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal

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Pedro Marques Endocrinology Department, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte (CHULN), Lisbon, Portugal

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Helder Simões Endocrinology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal

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Ricardo Rodrigues Unidade de Investigação em Patobiologia Molecular (UIPM), Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal

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Branca Maria Cavaco Unidade de Investigação em Patobiologia Molecular (UIPM), Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal

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Valeriano Leite Endocrinology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
Unidade de Investigação em Patobiologia Molecular (UIPM), Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
Nova Medical School: Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisbon, Portugal

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MKIs sorafenib and lenvatinib for the treatment of metastatic progressive differentiated thyroid cancer (DTC) of follicular origin. These drugs now play a major role as first-line targeted therapy for such tumors. Progression-free survival was 10

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Marine Sitbon Pharmacy Department, Hospital Saint-Louis APHP, Paris, France

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Porhuoy Chou Endocrine Oncology Department, Saint-Louis Hospital (AP-HP), Université Paris Cité, Paris, France

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Seydou Bengaly Endocrine Oncology Department, Saint-Louis Hospital (AP-HP), Université Paris Cité, Paris, France

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Brigitte Poirot Department of Molecular Oncology, Saint-Louis Hospital (AP-HP), Université Paris Cité INSERM U 944, CNRS UMR 7212, Paris, France

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Marie Laloi-Michelin Department of Internal Medicine, Hospital Lariboisière APHP, Paris, France

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Laure Deville Pharmacy Department, Hospital Saint-Louis APHP, Paris, France

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Atanas Pachev Radiology Department, Saint-Louis Hospital (AP-HP), Université Paris Cité, Paris, France

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Ahouefa Kowo-Bille Endocrine Oncology Department, Saint-Louis Hospital (AP-HP), Université Paris Cité, Paris, France

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Clement Dumont Medical Oncology Department, Saint-Louis Hospital (AP-HP), Université Paris Cité, Paris, France

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Cécile N Chougnet Endocrine Oncology Department, Saint-Louis Hospital (AP-HP), Université Paris Cité, Paris, France

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patient refused vandetanib treatment. Similarly, another team showed a rapid response with sorafenib, but sorafenib was not approved for MTC ( 10 ). Here, we report successful treatment of Cushing’s syndrome with RET-targeted therapy in a patient with

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Jihwan Yoo Department of Neurosurgery, Brain Tumor Center, Gangnam Severance Hospital, Seoul, Republic of Korea
College of Medicine, Yonsei University, Seoul, Republic of Korea

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Hee Jun Kim Department of Surgery, CHA Ilsan Medical Center, Cha University School of Medicine, Goyang-si, Republic of Korea

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Seok Mo Kim Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Seoul, Republic of Korea

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Hun Ho Park Department of Neurosurgery, Brain Tumor Center, Gangnam Severance Hospital, Seoul, Republic of Korea

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number of brain metastases). Progressive thyroid cancer was preferentially treated with RAI therapy; TKIs, including sorafenib or lenvatinib, were administered when the cumulative RAI dose exceeded 600 mCi. Following the confirmation of brain metastasis

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João Roque Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar Universitário Lisboa Norte, Hospital de Santa Maria, Lisbon, Portugal

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Tiago Nunes Silva Endocrinology, Diabetes and Metabolism Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
NOVA Medical School | Faculdade de Ciências Médicas of Universidade NOVA de Lisboa, Lisbon, Portugal
Unidade Investigação Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal

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Catarina Regala Endocrinology, Diabetes and Metabolism Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal

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Ricardo Rodrigues Unidade Investigação Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal

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Valeriano Leite Endocrinology, Diabetes and Metabolism Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
NOVA Medical School | Faculdade de Ciências Médicas of Universidade NOVA de Lisboa, Lisbon, Portugal
Unidade Investigação Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal

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kinase inhibitors (TKIs) have been used in PDTC patients enrolled in clinical trials targeting RAI-refractory DTC. To date, sorafenib and lenvatinib have been approved by the U.S. Food and Drug Administration and European Medical Agency for first

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Carla Colombo Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Daniele Ceruti Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Simone De Leo Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, Milan, Italy

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Grzegorz Bilo Department of Cardiology, San Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

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Matteo Trevisan Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Noemi Giancola Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Claudia Moneta Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Gianfranco Parati Department of Cardiology, San Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

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Luca Persani Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

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Laura Fugazzola Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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, 3 ). In particular, in Europe, sorafenib and lenvatinib (LEN) can be used as-first line and cabozantinib as second-line treatment for RAI-R DTCs, while vandetanib and cabozantinib are first-line compounds for MTCs. In phase III trials, these drugs

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Jaume Capdevila Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), IOB Quiron-Teknon, Barcelona, Spain

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Desiree’ Deandreis Department of Medical Sciences, Nuclear Medicine Unit, University of Turin, AOU Città della Salute e della Scienza, Turin, Italy

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Cosimo Durante Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy

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Sophie Leboulleux Service of Endocrinology, Diabetology, University Hospital Geneve, Geneve, Switzerland

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Markus Luster Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany

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Romana Netea-Maier Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands

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Kate Newbold Royal Marsden Hospital, London, United Kingdom

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Susanne Singer Institute of Medical Biostatistics Epidemiology and Informatics (IMBEI), University Medical Center of Johannes Gutenberg University, Mainz, Germany

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Gerasimos P Sykiotis Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

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Beate Bartes Association “Vivre sans Thyroïde”, Léguevin, France

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Kate Farnell Butterfly Thyroid Cancer Trust, Rowlands Gill, Tyne & Wear, UK

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Laura Deborah Locati Medical Oncology Unit, IRCCS ICS Maugeri, Pavia, Italy
Department of Internal Medicine and Therapeutics, University of Pavia, Italy

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survival of only 10% ( 7 , 9 , 10 ). Systemic therapies are an important treatment option for RAI refractoriness DTC. Among these, multikinase inhibitors (MKIs) are most frequently used, and lenvatinib, sorafenib, and cabozantinib have been approved for

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Ana Piñar-Gutiérrez UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España

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Ana R Romero-Lluch UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España

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Suset Dueñas-Disotuar UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España

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Irene de Lara-Rodríguez UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España

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María Ángeles Gálvez-Moreno Servicio de Endocrinología, Hospital Universitario Reina Sofía, Córdoba, España

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Tomás Martín-Hernández Servicio de Endocrinología, Hospital Universitario Virgen Macarena, Sevilla, España

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Jorge García-Alemán Servicio de Endocrinología, Hospital Universitario Virgen de la Victoria, Málaga, España

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Guillermo Martínez-de Pinillos Servicio de Endocrinología, Hospital Universitario Virgen de Valme, Sevilla, España

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Elena Navarro-González UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, España

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BM 150 (0–425) BM surgery 23 (36.5%) BM radiotherapy 32 (50.8%) TKI treatment 25 (39.7%)  Lenvatinib first line 8 (32%)  Sorafenib first line 7 (28%)  Lenvatinib second line 9 (36%)  Axitinib

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