Zhou CY, Ren XY, Li HH, Pan XM, Lan X, Duan D. Anlotinib plus albumin-bound paclitaxel induction-maintenance for sorafenib-refractory radioiodine-refractory differentiated thyroid cancer: A case report and review of literature. World J Clin Oncol 2026; 17(5): 119615 [DOI: 10.5306/wjco.v17.i5.119615]
Corresponding Author of This Article
Dong Duan, Department of Nuclear Medicine, Chongqing General Hospital, No. 118 Xingguang Avenue, Liangjiang New Area, Chongqing 400700, China. duandong26@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
May 24, 2026 (publication date) through May 23, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Clinical Oncology
ISSN
2218-4333
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Zhou CY, Ren XY, Li HH, Pan XM, Lan X, Duan D. Anlotinib plus albumin-bound paclitaxel induction-maintenance for sorafenib-refractory radioiodine-refractory differentiated thyroid cancer: A case report and review of literature. World J Clin Oncol 2026; 17(5): 119615 [DOI: 10.5306/wjco.v17.i5.119615]
World J Clin Oncol. May 24, 2026; 17(5): 119615 Published online May 24, 2026. doi: 10.5306/wjco.v17.i5.119615
Anlotinib plus albumin-bound paclitaxel induction-maintenance for sorafenib-refractory radioiodine-refractory differentiated thyroid cancer: A case report and review of literature
Chun-Yan Zhou, Xin-Yi Ren, Huan-Huan Li, Xiao-Mei Pan, Xin Lan, Dong Duan, Department of Nuclear Medicine, Chongqing General Hospital, Chongqing 400700, China
Author contributions: Zhou CY drafted the manuscript; Ren XY, Li HH, Pan XM, and Lan X collected the data; Duan D reviewed and edited the final manuscript; and all authors read and approved the final manuscript.
AI contribution statement: DeepL was used to assist with translation checking, and Grammarly was used for language polishing to improve grammar and readability. All content was subsequently reviewed and revised by the authors to ensure accuracy and integrity.
Supported by Natural Science Foundation of Chongqing, China, No. CSTB2023NSCQ-MSX0678.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Dong Duan, Department of Nuclear Medicine, Chongqing General Hospital, No. 118 Xingguang Avenue, Liangjiang New Area, Chongqing 400700, China. duandong26@163.com
Received: February 2, 2026 Revised: March 6, 2026 Accepted: April 1, 2026 Published online: May 24, 2026 Processing time: 108 Days and 3.1 Hours
Abstract
BACKGROUND
Treatment options for radioiodine-refractory differentiated thyroid cancer (RAIR-DTC) remain severely limited once resistance to first-line multikinase inhibitors, such as sorafenib, develops. Although the novel multikinase inhibitor anlotinib is approved for progressive RAIR-DTC, its combination with cytotoxic chemotherapy followed by maintenance therapy has not yet been reported. We present this case to introduce an undocumented salvage strategy utilizing anlotinib and albumin-bound paclitaxel. This report contributes a promising therapeutic alternative to the medical literature for this difficult-to-treat, sorafenib-resistant population.
CASE SUMMARY
We report the case of a 56-year-old woman who presented with worsening respiratory symptoms due to progressive pulmonary metastases and recurrent pleural effusion. She was diagnosed with RAIR-DTC. Despite prior thyroidectomy, three courses of radioactive iodine therapy, and first-line sorafenib, her disease progressed rapidly with enlarging structural lesions and rising thyroglobulin (Tg) levels. Following a multidisciplinary review, she received urgent salvage intervention. Sorafenib was replaced by anlotinib (12 mg daily, days 1 to 14 every 21 days) combined with albumin-bound paclitaxel (100 mg on days 1, 8, and 15) as induction, followed by anlotinib monotherapy maintenance. Consequently, pulmonary lesions and pleural effusion markedly regressed, achieving a confirmed partial response per RECIST version 1.1. Serum Tg decreased from 106.28 ng/mL to 31.89 ng/mL. She has maintained a progression-free survival exceeding 38 months with tolerable adverse effects.
CONCLUSION
Anlotinib combined with albumin-bound paclitaxel, followed by anlotinib maintenance, may represent a promising salvage strategy for sorafenib-refractory RAIR-DTC, which warrants further investigation in larger prospective trials.
Core Tip: Effective salvage treatments for radioiodine-refractory differentiated thyroid cancer (RAIR-DTC) following sorafenib failure remain severely limited. This case report presents an innovative combination and maintenance strategy. By employing anlotinib plus albumin-bound paclitaxel as induction therapy to potentially promote vascular normalization and enhance cytotoxic drug delivery, followed by anlotinib maintenance, a patient with metastatic RAIR-DTC achieved a confirmed partial response. With manageable toxicity and progression-free survival exceeding 38 months, this case suggests that the anlotinib-based regimen may provide durable disease control and warrants further prospective evaluation in patients who have exhausted first-line multikinase inhibitors.
