Immunotherapy for advanced thyroid cancers — rationale, current advances and future strategies

In the past decade, the field of cancer immunotherapy has been revolutionized by immune checkpoint blockade (ICB) technologies. Success across a broad spectrum of cancers has led to a paradigm shift in therapy for patients with advanced cancer. Early data are now accumulating in progressive thyroid cancers treated with single-agent ICB therapies and combination approaches that incorporate ICB technologies. This Review discusses our current knowledge of the immune response in thyroid cancers, the latest and ongoing immune-based approaches, and the future of immunotherapies in thyroid cancer. Physiologically relevant preclinical mouse models and human correlative research studies will inform development of the next stage of immune-based therapies for patients with advanced thyroid cancer. With immune checkpoint blockade (ICB) technologies increasingly being used in cancer immunotherapy, early data suggest that ICB therapies could be effective in thyroid cancer. This Review discusses our current knowledge of the immune response in thyroid cancers, the latest and ongoing immune-based approaches and the future of immunotherapies in thyroid cancer. Key points Despite advances in treatment strategies, patients with advanced thyroid cancers would benefit from novel therapies. Advanced thyroid cancers are commonly infiltrated by immune cells, including CD8 + T cells, but little is known about the tumour-specific T cell response. A subset of patients has received clinical benefit from immune checkpoint blockade therapies; however, the majority achieve only a partial response. Novel combination therapies that target both the tumour and the immune response are under investigation. Additional studies are necessary to better understand the potential of the antitumour immune response and T cell-based therapies for patients with advanced thyroid cancer.