Approach to the management of patients with newly diagnosed anaplastic thyroid cancer

AJCC: American Joint Committee on Cancer; PET: positron emission tomography; CT: computed tomography; MRI: magnetic resonance imaging.
* Neck ultrasound, PET/CT (neck to pelvis), brain MRI or CT. All anaplastic cancers are considered stage IV cancers. Best supportive care/hospice is an alternative to mutational testing if aggressive care is not desired.
¶ Specific inhibitors of oncogenic ALK, NTRK, or RET fusion mutations can be considered for unresectable stage IVB disease or stage IVC disease, preferably within the context of a clinical trial.
Δ Surgery followed by chemoradiation is an alternative in patients with resectable IVB disease.
◊ Consider surgery for resectable cervical disease if low volume M1, followed by chemoradiation.
§ If unfavorable response to dabrafenib plus trametinib, options include chemoradiation, clinical trials, and best supportive care.