Systemic Treatment of Thyroid Cancer: ASCO Guideline

ASCO Guidelines provide recommendations with comprehensive review and analyses of the relevant literature for each recommendation, following the guideline development process as outlined in the ASCO Guidelines Methodology Manual . ASCO Guidelines follow the ASCO Conflict of Interest Policy for Clinical Practice Guidelines . Clinical Practice Guidelines and other guidance (“Guidance”) provided by ASCO is not a comprehensive or definitive guide to treatment options. It is intended for voluntary use by clinicians and should be used in conjunction with independent professional judgment. Guidance may not be applicable to all patients, interventions, diseases, or stages of diseases. Guidance is based on review and analysis of relevant literature and is not intended as a statement of the standard of care. ASCO does not endorse third-party drugs, devices, services, or therapies and assumes no responsibility for any harm arising from or related to the use of this information. See complete disclaimer in Appendix 1 and Appendix 2 (online only) for more . PURPOSE To provide evidence-based recommendations on the use of systemic therapy in different types of thyroid cancers. METHODS The American Society of Clinical Oncology convened a multidisciplinary Expert Panel to evaluate the evidence and formulate recommendations. The literature search included studies published between January 1, 2000, and November 5, 2025, and comprised systematic reviews, meta-analyses, randomized controlled trials, and observational studies. Outcomes of interest included overall survival, disease-free survival, and safety. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS A total of 66 publications were identified to inform the evidence base for this guideline. RECOMMENDATIONS Evidence-based recommendations address the use of systemic therapy in patients with well-differentiated, differentiated high-grade or poorly differentiated, anaplastic, and medullary thyroid cancer. Additional information is available at www.asco.org/head-neck-cancer-guidelines .