Session Description
Thyroid tumorigenesis is driven by well described oncogenic driver alterations. In 2014, the TCGA published the “Integrated genomic characterization of papillary thyroid carcinoma” in adults suggesting that reclassification of thyroid cancers into molecular subtypes better reflect differentiation and invasive potential compared to traditional histopathological classification. Similar data in pediatrics has been accumulating over the last decade, supporting incorporation of oncogenic drivers to increase the accuracy of identifying a thyroid malignancy in nodules with indeterminate cytology, and, potentially, to optimize stratification of surgery. With the availability of FDA approved oncogene specific inhibitors, there is also increased research in how to incorporate these oral chemotherapeutic agents in both the neoadjuvant and adjuvant setting. This lecture will provide a case-based update on current research focusing on the use of somatic oncogenic driver alterations in an effort to improve stratification of care in pediatric patients with thyroid nodules and differentiated thyroid cancer.