Efficacy and safety of anlotinib combined with chemotherapy plus anlotinib maintenance in Radioiodine-refractory differentiated thyroid cancer: a case report and literature review

Background: Radioiodine-refractory differentiated thyroid cancer is one of the leading causes of mortality among patients with thyroid cancer, presenting significant clinical challenges in both diagnosis and management. In addition to sorafenib and levatinib, China's self-developed tyrosine kinase inhibitor, anlotinib, has been approved by the national medical products administration for the treatment of progressive, locally advanced or metastatic radioiodine-refractory differentiated thyroid cancer. Despite the potential of single-agent therapy to improve treatment efficacy, the management of patients with advanced radioiodine-refractory differentiated thyroid cancer who have exhausted first- and second-line treatments remains a considerable challenge, with limited chances of achieving satisfactory outcomes. Recent research has shown that anlotinib combined with chemotherapy has an enhanced antitumor efficacy and a tolerable safety profile in patients with triple-negative breast cancer and advanced ovarian cancer. However, the efficacy and safety of anlotinib with chemotherapy for radioiodine-refractory differentiated thyroid cancer have not been reported in the literature. Case presentation: Here, we present a case of metastatic radioiodine-refractory differentiated thyroid cancer that was treated with a combination of anlotinib and chemotherapy, along with anlotinib maintenance therapy after the failure of sorafenib treatment, resulting in favorable outcomes. Conclusions: The combination of anlotinib and chemotherapy, followed by anlotinib maintenance, showed promising efficacy and manageable toxicity in the treatment of advanced radioiodine-refractory differentiated thyroid cancer.