Anaplastic Thyroid Carcinoma: A Contemporary Review of Challenges and Advances.

OBJECTIVE

To review the epidemiology, molecular landscape, diagnostic strategies, and treatment options for anaplastic thyroid carcinoma (ATC), with emphasis on the role of targeted therapy and multimodal care.

METHODS

A comprehensive review of current literature and clinical guidelines was performed, focusing on diagnostic approaches, molecular profiling, and treatment strategies including surgery, radiation, systemic therapy, and emerging targeted and immunotherapies.

RESULTS

ATC represents <2% of thyroid cancers but accounts for over 50% of thyroid-cancer related mortality, with median survival of <1 year. Timely biopsy and molecular testing, particularly for BRAFV600E, allow initiation of targeted therapy. For resectable disease, surgery with adjuvant chemoradiation improves survival. In unresectable or metastatic disease, dabrafenib plus trametinib has significantly improved outcomes in BRAFV600E-mutant ATC, while immunotherapy and other targeted agents show emerging promise.

CONCLUSIONS

Despite advances, ATC remains highly lethal. Early multidisciplinary care centered around individual patient care goals expedited molecular testing, and enrollment in clinical trials are critical to improving survival and guiding future therapeutic strategies.