47
Assessment
for
Response
c
First-line gene-specific therapy in most patients with RET or NTRK fusion-positive disease is
preferable. MKIs are recommended in general in patients with BRAF V600E or RAS-mutated DTC
unless based on comorbidities/side effect concerns, patient preference, or clinical trial options.
d
When treatment is discontinued due to treatment related adverse events (TRAE), consider 2nd-line
therapy only aer disease progression.
Treatment
Decision
Assess
response and
continue if
treatment
tolerable
and no
progression
d
Progression
or intolerable
side effects
(see Figure 10)
Comprehensive
somatic
genomic testing
Consider
local
therapy
RET or NTRK
fusion-
positive
RET and
NTRK
wildtype
Individualize
timing of
treatment
initiation
Lenvatinib
or other
MKI
c
Treatment
decision
RET or TRK
inhibitor
c
