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RET Gene Testing in Medullary Thyroid Cancer

Join Kanishka Desai, MD, as she and Mimi Hu, MD, discuss the revolutionary role of RET inhibitors in treating advanced medullary thyroid cancer (MTC). This episode, produced in collaboration with the American Thyroid Association and Medscape, explores the shift in MTC management from non-specific multi-kinase inhibitors to targeted precision therapy. Mimi Hu, MD, a national leader in thyroid cancer and hereditary endocrine syndromes at the University of Texas MD Anderson Cancer Center, provides expert insight into why RET alterations are actionable targets for MTC. Learn about the current landscape of RET inhibitors, including the key differences and improved tolerability compared to older treatments like cabozantinib and vandetanib. The discussion covers critical considerations for patient management, side-effect mitigation (like addressing T3 levels and fatigue), monitoring protocols, and future directions for patients who develop drug resistance. The proven efficacy and favorable tolerability profile of these targeted agents are dramatically changing the long-term outlook for MTC patients. Key Topics Discussed: Understanding the distinction and rarity of medullary thyroid cancer. The role of RET mutations in both hereditary and sporadic MTC. The groundbreaking efficacy and improved tolerability of specific RET inhibitors. Clinical monitoring strategies for patients on targeted therapy. 00:00 - Introduction to the Thyroid Stimulating Podcast 00:35 - Medullary Thyroid Cancer (MTC): A Unique Form of Thyroid Cancer 02:48 - MTC vs. Differentiated Thyroid Cancers: Key Differences 04:36 - Standard of Care and Genetic Testing for MTC 09:51 - Defining Advanced MTC and When to Start Systemic Therapy 13:25 - Understanding RET Inhibitors and Their Targeted Mechanism 16:50 - Side Effects of RET Inhibitors and Patient Tolerance 22:13 - Efficacy and Clinical Data on RET Inhibitors 26:30 - Monitoring and Managing Patients on RET Inhibitors 31:41 - Drug Resistance, Mutations, and Future Directions 38:33 - Key Takeaways on RET Inhibitors for MTC Managing resistance and future treatment options for advanced MTC. https://www.medscape.com/viewarticle/...