Condition

Thyroid cancer

Clinical trials and treatment information for Thyroid cancer

2M
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.

1
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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65
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

$0

Monitoring

$1,000

Side Effects

$300

Total Annual

$1,300

Cost-Effectiveness

EXCELLENT

QALYs Gained

4

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
2
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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30
DangerousModerateSafe

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)

18

Number Needed to Harm (NNH)

5

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

$0

Monitoring

$1,500

Side Effects

$300

Total Annual

$1,800

Cost-Effectiveness

EXCELLENT

QALYs Gained

2

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
3
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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65
DangerousModerateSafe

Time to Effect

2-4 weeks to achieve stable TSH

Duration

Lifetime

Response Rate

99%

Remission Rate

90%

Number Needed to Treat (NNT)

7

Number Needed to Harm (NNH)

15

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

3

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
4
Lenvatinib
75% Effectiveness• 90% Confidence• 30% Safety• 36 trials• 5K participants
HIGH EvidenceModerate ValueDose: 24 mg orally once daily
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30
DangerousModerateSafe

Time to Effect

1-3 months

Duration

Until progression or unacceptable toxicity

Response Rate

65%

Remission Rate

1%

Number Needed to Treat (NNT)

2

Number Needed to Harm (NNH)

3

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
5
Sorafenib
60% Effectiveness• 90% Confidence• 30% Safety• 20 trials• 4K participants
HIGH EvidencePoor ValueDose: 400 mg orally twice daily
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30
DangerousModerateSafe

Time to Effect

1-3 months

Duration

Until progression or unacceptable toxicity

Response Rate

12%

Remission Rate

0.5%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

3

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
6
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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25
DangerousModerateSafe

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)

4

Number Needed to Harm (NNH)

7

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

$0

Monitoring

$1,500

Side Effects

$1,000

Total Annual

$2,500

Cost-Effectiveness

MODERATE

QALYs Gained

1

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