common cancer by 2030. While survival rates are generally high, drug resistance and reduced sensitivity to radioactive iodine (RAI) remain major challenges. New research highlights the role of reactive oxygen species (ROS) and autophagy in driving resistance and shaping potential therapies.
Most cases are Differentiated Thyroid Cancer (DTC), especially Papillary Thyroid Carcinoma (PTC), which accounts for about 85% of thyroid cancers. DTC generally has a favorable prognosis, but metastatic cases often lose RAI sensitivity, partly due to decreased sodium/iodide symporter activity. Other subtypes include Medullary Thyroid Cancer (MTC), linked to RET gene changes, and the rare but aggressive Anaplastic Thyroid Cancer (ATC).
ROS levels vary by subtype: low in DTC, intermediate in MTC, and very high in ATC. While moderate ROS can drive tumor growth through PI3K/AKT and MAPK pathways, excessive ROS can kill cancer cells. Understanding these patterns may guide ROS-targeted therapies to overcome resistance and improve outcomes.