© 2021 American yroid Association. All rights reserved.
8
Systemic Therapy
• Systemic therapy includes both chemotherapy and targeted
therapy
• For those wishing to undertake an aggressive form of
treatment, chemotherapy is oen begun immediately while
awaiting results of genetic mutation tests for any tumors, and
may also be used alongside radiation therapy.
• New medications called targeted therapies are available when
genetic mutations are present. e most common genetic
mutations, for which drugs are available, are BRAF V600E,
NTRK, ALK and RET.
• Systemic therapy can oen come with side effects, and during
treatment you may need additional supportive care and
medications for nausea and vomiting, pain, bone density loss,
and more. is is why it's important to weigh the pros and
cons when deciding on treatment options, especially those
that are most aggressive.
TARGETED THERAPY DRUG TABLE
Drug Genetic alterations
dabrafenib + trametinib BRAF V600E
larotrectinib NTRK
entrectinib NTRK
pralsetinib RET
selpercatinib RET
crizotinib ALK
ceritinib ALK
alectinib ALK
pembrolizumab High PD-L1 and/or
≥10 mutations/Mb TMB
