About RET+ advanced thyroid cancers

Utilize biomarker testing in advanced thyroid cancers to determine appropriate treatment for your patients

There are several types of thyroid cancer, but most are differentiated thyroid cancers17,18

Thyroid cancers are classified according to the types of cells from which they originate. The cell type can help to determine prognosis, as well as clinical management of the disease.17,18

Thyroid types chart

There are less common types of thyroid cancer, such as lymphomas, sarcomas, and other rare tumors.17

RET+=rearranged during transfection positive.

Biomarkers are known to drive oncogenic growth in certain advanced thyroid cancers3,19-28

Differentiated thyroid cancer (DTC)



RET fusions19-21


NTRK rearrangements22


ALK fusions23


BRAF V600E mutations3

PTC (≤18 years of age)


RET fusions24


NTRK rearrangements24


BRAF V600E mutations24

Medullary thyroid cancer (MTC)

~90% of patients with metastatic disease have RET mutations25


Medullary thyroid cancer donut SMTC

~50% RET26-28


Medullary thyroid cancer donut FMTC

~100% RET26-28

*Germline as part of MEN2 syndrome.

ALK=anaplastic lymphoma kinase; BRAF=B-Raf proto-oncogene; FMTC=familial medullary thyroid cancer; MEN2=multiple endocrine neoplasia type 2; NTRK=neurotrophic tyrosine receptor kinase; PTC=papillary thyroid cancer; SMTC=sporadic medullary thyroid cancer.

Comprehensive biomarker testing is important in advanced thyroid cancers due to the prevalence of actionable biomarkers19,22,25,29

Testing in DTC

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) recommend genomic testing to identify actionable mutations for structurally persistent locally advanced or metastatic DTC not amenable to radioiodine therapy3

  • Test for RET fusions, ALK fusions, NTRK fusions, BRAF mutations, and TMB3

DNA- or RNA-based comprehensive profiling may be appropriate.30

Testing in MTC

NCCN Guidelines® recommend germline RET testing in all patients with a diagnosis of MTC3

  • ALL patients with MTC should be tested for inherited risk3
  • Genetic RET testing should be recommended in all patients with a new diagnosis of MTC3

DNA-based comprehensive profiling for patients requiring systemic therapy may be appropriate, but FISH and RNA panels are not.30

NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. FISH=fluorescence in situ hybridization; NCCN=National Comprehensive Cancer Network®; TMB=tumor mutational burden.

RET alterations can be identified via various testing methodologies, including NGS, PCR, and FISH19

It is important to consider that not every laboratory test can detect RET mutations and/or fusions.

Talk to your pathologist to determine the most appropriate lab for testing your patient for biomarkers

NGS=next-generation sequencing; PCR=polymerase chain reaction.

The treatment landscape for advanced thyroid cancer is evolving

Prior to 2020, multikinase inhibitors were approved for the treatment of certain thyroid cancers, but none were specifically approved for a RET+ biomarker-defined patient population.19 With the approval of RET-directed inhibitors, healthcare providers can utilize strategies to specifically target RET as an actionable biomarker in certain advanced thyroid cancers.1,31

Select patients for treatment based on the presence of a RET gene fusion or mutation. Consider a selectively designed RET inhibitor1

An FDA-approved test for the detection of RET gene fusions and mutations is not currently available.