Condition

Thyroid cancer

Clinical trials and treatment information for Thyroid cancer

People Affected

200

Active Trials

298K

New Cases/Year

45K

Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

Thyroidectomy

95% Effectiveness• 95% Confidence• 65% Safety• 195 trials• 1M participants

HIGH EvidenceExcellent Value

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Comparative Safety Scale(Higher is safer)

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DangerousModerateSafe

Time to Effect

Immediate (tumor removal)

Duration

Single procedure

Response Rate

90%

Remission Rate

85%

Common Side Effects:

Temporary hypoparathyroidism/hypocalcemia: 15%

Permanent hypoparathyroidism/hypocalcemia: 2%

Temporary recurrent laryngeal nerve injury/hoarseness: 7%

Permanent recurrent laryngeal nerve injury/hoarseness: 1%

Bleeding/hematoma: 2%

Infection: 0.5%

Annual Cost of Care

Drug Cost

Monitoring

$1,000

Side Effects

$300

Total Annual

$1,300

Cost-Effectiveness

EXCELLENT

QALYs Gained

ICER

$11,921/QALY

Treatment Outcomes

Primary Outcomes

5-Year Disease Recurrence Rate (for Intermediate-Risk DTC)Estimated 5-year recurrence rate for untreated or inadequately treated intermediate-risk Differentiated Thyroid Cancer (DTC): 25%

-80% (Reduction to ~5% (20 percentage points decrease))

5-Year Disease-Specific Mortality Rate (for Intermediate-Risk DTC)Estimated 5-year disease-specific mortality for untreated or inadequately treated intermediate-risk Differentiated Thyroid Cancer (DTC): 10%

-90% (Reduction to ~1% (9 percentage points decrease))

Post-Treatment Stimulated Serum Thyroglobulin (indicating residual disease)Pre-ablation stimulated Tg: 5.0 ng/mL

-96% (Reduction to <0.2 ng/mL (undetectable, -4.8 ng/mL))

Local Compression Symptoms Severity (Dyspnea Scale)Dyspnea Severity Score (0-10 scale): 6/10 (moderate)

-83.3% (Reduction of 5 points)

Secondary Benefits

Health-Related Quality of Life (EORTC QLQ-C30 Global Health Status)EORTC QLQ-C30 Global Health Status score: 65/100 (pre-op, impacted by cancer symptoms/anxiety)

+15.4% (Increase of 10 points)

Cancer-Related Anxiety (GAD-7 Score)GAD-7 score: 12/21 (moderate anxiety)

-50% (Reduction of 6 points)

Vocal Fatigue Index (VFI) Score (if pre-existing due to tumor)Vocal Fatigue Index (VFI) score: 25/60 (moderate fatigue/effort)

+40% (Improvement of 10 points)

Common Side Effects

Temporary hypoparathyroidism/hypocalcemia

+15%

Permanent hypoparathyroidism/hypocalcemia

+2%

Temporary recurrent laryngeal nerve injury/hoarseness

+7%

Clinical Trial Phases:

Phase 4

Radioactive Iodine-131 (I-131) Therapy

90% Effectiveness• 90% Confidence• 30% Safety• 14 trials• 50K participants

HIGH EvidenceExcellent ValueDose: 30-200 mCi

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Comparative Safety Scale(Higher is safer)

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Time to Effect

Weeks to months for ablation, sustained effect

Duration

Single dose or few doses

Response Rate

85%

Remission Rate

85%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Salivary gland swelling/pain: 20%

Taste disturbance: 15%

Neck pain/swelling: 30%

Nausea/vomiting: 5%

Fatigue: 10%

Increased risk of secondary malignancies (long-term): 0.5%

Annual Cost of Care

Drug Cost

Monitoring

$1,500

Side Effects

$300

Total Annual

$1,800

Cost-Effectiveness

EXCELLENT

QALYs Gained

ICER

$26,012/QALY

Treatment Outcomes

Primary Outcomes

Stimulated Serum Thyroglobulin (Tg) LevelPre-RAI, TSH-stimulated: 10 ng/mL

-99% (-9.9 ng/mL (to <0.1 ng/mL))

Thyroglobulin Antibody (TgAb) LevelPre-RAI: 100 IU/mL

-70% (-70 IU/mL (to 30 IU/mL))

Largest Diameter of I-131 Avid Metastatic Lesion2.5 cm

-60% (-1.5 cm (to 1.0 cm))

Secondary Benefits

FACT-Thyroid (FACT-Th) Total ScorePre-RAI: 100/160

+15% (+15 points (to 115/160))

Hospital Anxiety and Depression Scale (HADS) Anxiety SubscalePre-RAI: 12/21

-33% (-4 points (to 8/21))

Fatigue Severity Scale (FSS) ScorePre-RAI: 5.5/7

-25% (-1.4 points (to 4.1/7))

Common Side Effects

Salivary gland swelling/pain

+20%

Taste disturbance

+15%

Neck pain/swelling

+30%

Clinical Trial Phases:

Phase 4

Levothyroxine (TSH Suppression Therapy)

88% Effectiveness• 98% Confidence• 65% Safety• 6 trials• 500K participants

HIGH EvidenceExcellent ValueDose: 75-200 mcg daily

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Comparative Safety Scale(Higher is safer)

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DangerousModerateSafe

Time to Effect

2-4 weeks to achieve stable TSH

Duration

Lifetime

Response Rate

99%

Remission Rate

90%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Palpitations/Tachycardia (from over-suppression): 7%

Anxiety/Insomnia (from over-suppression): 6%

Weight loss (from over-suppression): 5%

Osteoporosis (long-term, high doses): 3%

Annual Cost of Care

Drug Cost

$30

Monitoring

$300

Side Effects

$50

Total Annual

$380

Cost-Effectiveness

EXCELLENT

QALYs Gained

ICER

$15,000/QALY

Treatment Outcomes

Primary Outcomes

TSH Level2.5 mIU/L

-96% (-2.4 mIU/L)

Serum Thyroglobulin (on suppression)2.0 ng/mL

-90% (-1.8 ng/mL)

5-Year Thyroid Cancer Recurrence Rate15%

-50% (-7.5 percentage points)

Secondary Benefits

Lumbar Spine Bone Mineral Density1.0 g/cm^2

-2% (-0.02 g/cm^2)

Resting Heart Rate70 bpm

+8% (+5.6 bpm)

Thyroid Cancer-Specific Quality of Life (THYCA-QoL)75/100

-3% (-2.25 points)

Common Side Effects

Palpitations/Tachycardia (from over-suppression)

+7%

Anxiety/Insomnia (from over-suppression)

+6%

Weight loss (from over-suppression)

+5%

Clinical Trial Phases:

Phase 4

Lenvatinib

75% Effectiveness• 90% Confidence• 30% Safety• 36 trials• 5K participants

HIGH EvidenceModerate ValueDose: 24 mg orally once daily

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Comparative Safety Scale(Higher is safer)

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Time to Effect

1-3 months

Duration

Until progression or unacceptable toxicity

Response Rate

65%

Remission Rate

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Hypertension: 70%

Fatigue: 67%

Diarrhea: 59%

Nausea: 45%

Decreased appetite: 39%

Weight decrease: 35%

Proteinuria: 32%

Palmar-plantar erythrodysesthesia syndrome (PPE): 34%

Annual Cost of Care

Drug Cost

$200,000

Monitoring

$4,000

Side Effects

$7,000

Total Annual

$211,000

Cost-Effectiveness

MODERATE

QALYs Gained

1.2

ICER

$130,000/QALY

Cost per Remission

$21,100,000

Cost per Responder

$324,615

Treatment Outcomes

Primary Outcomes

Target Lesion Diameter Reduction (RECIST)100% of baseline diameter

-45% (e.g., -4.5 cm for a 10 cm lesion)

Progression-Free Survival (median duration)3.6 months (placebo/control arm)

+408.3% (+14.7 months)

Serum Thyroglobulin LevelElevated, e.g., 500 ng/mL

-60% (-300 ng/mL)

Secondary Benefits

Global Health Status/QoL (EORTC QLQ-C30)Baseline score: e.g., 60/100

+5% (+3 points (on 0-100 scale))

Pain Intensity (NRS 0-10)Moderate pain: 5/10

-30% (-1.5 points)

ECOG Performance Status1 (ambulatory, restricted in physically strenuous activity)

-20% (-0.2 points)

Common Side Effects

Hypertension

+70%

Fatigue

+67%

Diarrhea

+59%

Clinical Trial Phases:

Phase 3Phase 4

Sorafenib

60% Effectiveness• 90% Confidence• 30% Safety• 20 trials• 4K participants

HIGH EvidencePoor ValueDose: 400 mg orally twice daily

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Time to Effect

1-3 months

Duration

Until progression or unacceptable toxicity

Response Rate

12%

Remission Rate

0.5%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Palmar-plantar erythrodysesthesia syndrome (PPE): 76%

Diarrhea: 69%

Alopecia: 67%

Rash/desquamation: 55%

Fatigue: 51%

Hypertension: 41%

Weight loss: 37%

Annual Cost of Care

Drug Cost

$190,000

Monitoring

$4,000

Side Effects

$6,000

Total Annual

$200,000

Cost-Effectiveness

POOR

QALYs Gained

0.8

ICER

$300,000/QALY

Cost per Remission

$40,000,000

Cost per Responder

$1,666,667

Treatment Outcomes

Primary Outcomes

Median Progression-Free Survival5.8 months (placebo in advanced DTC)

+86.2% (+5.0 months)

Sum of diameters of target lesions (RECIST)100 mm

-25% (-25 mm)

Serum Thyroglobulin (Tg)High, e.g., 500 ng/mL

-35% (-175 ng/mL)

Secondary Benefits

Pain Intensity (BPI-SF Worst Pain)Moderate, e.g., 5/10

-20% (-1 point)

Circulating Tumor Cells (CTCs)Elevated, e.g., 5 cells/7.5 mL

-50% (-2.5 cells/7.5 mL)

Common Side Effects

Palmar-plantar erythrodysesthesia syndrome (PPE)

+76%

Diarrhea

+69%

Alopecia

+67%

Clinical Trial Phases:

Phase 3Phase 4

External Beam Radiation Therapy (EBRT)

55% Effectiveness• 85% Confidence• 25% Safety• 9 trials• 30K participants

MODERATE EvidenceModerate ValueDose: 40-70 Gy in 1.8-2 Gy fractions

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Time to Effect

Weeks to months for tumor control

Duration

5-7 weeks (daily sessions)

Response Rate

65%

Remission Rate

10%

Number Needed to Treat (NNT)

Number Needed to Harm (NNH)

Common Side Effects:

Skin redness/irritation: 70%

Dysphagia/sore throat: 40%

Fatigue: 40%

Hoarseness: 20%

Hypothyroidism (long-term): 10%

Annual Cost of Care

Drug Cost

Monitoring

$1,500

Side Effects

$1,000

Total Annual

$2,500

Cost-Effectiveness

MODERATE

QALYs Gained

ICER

$100,000/QALY

Treatment Outcomes

Primary Outcomes

Locoregional Recurrence Rate25% (expected risk without EBRT in high-risk patients)

-60% (-15% absolute risk reduction (e.g., from 25% to 10%))

5-year Overall Survival Rate50% (expected rate without EBRT in advanced cases)

+30% (+15% absolute survival improvement (e.g., from 50% to 65%))

Pain Severity (NRS Scale)6/10 (Numerical Rating Scale)

-50% (-3 points on NRS scale)

Dysphagia Severity (MDADI Score)60/100 (MD Anderson Dysphagia Inventory)

+25% (+15 points on MDADI scale)

Secondary Benefits

Quality of Life (EORTC QLQ-C30 GHS)50/100 (EORTC Global Health Status)

+15% (+7.5 points on EORTC QLQ-C30 GHS)

Voice Handicap Index (VHI-30)40/120 (moderate handicap)

-37.5% (-15 points on VHI-30)

Hospitalization Rate (for local complications)20% (expected rate in advanced disease without EBRT)

-50% (-10% absolute reduction (e.g., from 20% to 10%))

Common Side Effects

Skin redness/irritation

+70%

Dysphagia/sore throat

+40%

Fatigue

+40%

Clinical Trial Phases:

Phase 4