Consensus on the management of advanced medullary thyroid carcinoma on behalf of the Working Group of Thyroid Cancer of the Spanish Society of Endocrinology (SEEN) and the Spanish Task Force Group for Orphan and Infrequent Tumors (GETHI)

Abstract Background In Spain medullary thyroid carcinoma (MTC) would not exceed 80 new cases per year and less than half of them would be good candidates for systemic treatment with novel agents. Methods Relevant literature was reviewed, including PubMed searches supplemented with additional articles. Results The consensus summarizes the clinical outcomes in terms of activity and toxicity of each of the available drugs. A brief summary of the minimum requirements in terms of follow up and genetic counseling around MTC is also included. Conclusions Only those patients with objective imaging progression in the last 12–14 months with large volume of disease are clear candidates to start systemic treatment. However, those patients with low disease volume should be considered for ‘wait and see’ strategy until symptoms of the disease appear. Multidisciplinary approach for the management of MTC patient is mandatory nowadays.