Thyroid Cancer and Personalized Medicine

During the last decade, the incidence of thyroid nodules and cancer is increased and a higher demand for the diagnosis of thyroid nodules, and the treatment of this aggressive disease appeared. Molecular biology has given important contributions in the understanding of the mechanism of thyroid cancer, and it is used for the diagnosis, treatment, and prognosis of thyroid cancers successfully. Testing of fine needle aspiration (FNA) samples, from thyroid nodules, for a panel of mutations (typically includes BRAF, RAS, RET/PTC, VEGFR, EGFR, and PAX8/PPARg), proteomics, and metabolomics aimed by many researchers. The low-cost of individual genomic analysis provides a new era of personalized, patient-specific care. The lack of effective therapies for DTC, resistant to radioiodine and traditional therapies, is now being overcome by the development of targeted novel compounds in the context of personalized medical treatment. The increasing complexity of the diagnostic and therapy of thyroid cancer needs increased effort to personalize the diagnosis and the treatment, to reach the best and maximum success, and avoiding unnecessary and potentially harmful treatments. Nowadays, ctDNA results will be a useful and additional tool, while tumor biopsy will remain the gold standard, as it yields important information about tumor type, morphology, and origin of tumor, genetic or epigenetic alterations. A liquid biopsy is defined as circulating tumor cells (CTCs) and fragments of circulating tumor DNA (ctDNA) shed into the bloodstream from primary and metastatic tumor deposits. Using of ctDNA is superior to a non-invasive and cost-effective solution to identify reliable biomarkers for measuring tumor growth, metastasis and response to treatments. Molecular imaging based personalized therapy has been a fascinating concept for individualized therapeutic strategy, which is able to attain the highest efficacy and reduce adverse effects in certain patients.Finally, for molecular diagnosis, molecular imaging, and molecular treatment of the thyroid cancers, more and more, personalized medicine made a hopeful light in this ear and the future of this field will belong to personalized medicine in a belief of cancer researchers.