Current perspectives on the pharmacotherapeutic management of Anaplastic thyroid cancer

INTRODUCTION: Anaplastic thyroid cancer (ATC) is one of the most aggressive and lethal human malignancies, with poor response to conventional therapies. Management of ATC relies on multidisciplinary approach that integrates surgery, radiation therapy, systemic therapy, and airway management to optimize patient outcomes. New emerging targeted therapies have substantially improved clinical patients outcomes. However, ATC remains one of the most aggressive malignancy with an overall survival lower than one year. AREAS COVERED: Treatment of ATC represents a significant clinical challenge in oncology. We aim to review current therapies and perspectives on the pharmacotherapeutic management of ATC (search on PubMed database). EXPERT OPINION: Targeted therapy may significantly influence disease progression; consequently, early molecular profiling is recommended to support optimal treatment selection. The detection of BRAF and RAS mutation can provide valuable guidance for personalized therapeutic strategies. In patients with BRAF-mutated ATC dabrafenib plus trametinib has been approved. Tyrosine kinase inhibitors are used in the treatment of ATC, and lenvatinib has been approved in Japan. Immunotherapy has shown encouraging results and represents a promising treatment strategy. Actually, the treatment of pembrolizumab plus lenvatinib is approved in Italy. Currently, different clinical trials are exploring new agents and combination regimens to further improve patient outcomes.