Multidisciplinary Pediatric Thyroid Cancer Clinic

Multidisciplinary Pediatric Thyroid Cancer Clinic Offers Integrated Care Model

UCSF Benioff Children’s Hospitals have launched a multidisciplinary Pediatric Thyroid Cancer Clinic to provide comprehensive, research-driven care for children and adolescents with thyroid cancer. Through this clinic, patients have access to multiple clinical trials specifically for pediatric thyroid cancer.

Key differences in pediatric thyroid cancer

Thyroid cancer is far more common in adults than in children. It presents differently when diagnosed in children, and adult treatment protocols may not be appropriate for young patients.

“Thyroid cancer in children is fundamentally different from what we see in adults,” explains Maya Lodish, MD, pediatric endocrinologist and director of the UCSF Pediatric Thyroid Cancer Clinic. “Children often have more advanced disease at diagnosis, with more frequent lymph node involvement and distant metastases. However, with the proper treatment, pediatric patients have excellent long-term prognosis.”

The team addresses pediatric challenges with a specialized approach. They deliver individualized care using data from mutational analysis when available. Next, they determine appropriate treatment plans that follow standards of care while minimizing complications that could affect growing children. The team also manages developmental needs, impacts on growth and puberty, fertility preservation and mental health.

Why a multidisciplinary approach matters

The clinic’s leadership team includes pediatric endocrinologists Lodish and Tina Hu, MD, and pediatric oncologist Arun Rangaswami, MD. Together with fellow physicians, advanced practice providers, genetic counselors and nurses, they provide an expert blend of thyroid disease management and oncology expertise.

“A multidisciplinary approach allows us to meet the unique needs of our young patients,” says Lodish. “We provide an integrated care model, from diagnosis through surgery, radioactive iodine treatment, and long-term monitoring and follow-up.”

The clinic also partners with a tumor board. The specialists on the tumor board review cases and develop customized treatment plans using their combined expertise. These experts include:

• Endocrinologists
• Oncologists
• Otolaryngologists
• Radiologists
• Radiation oncologists
• Pathologists
• Molecular pathologists
• Genetic counselors

Research and precision medicine

Clinical trials are a key part of the clinic’s care. The team is currently enrolling patients in three national studies. UCSF is one of only two sites on the West Coast to offer these trials. “As an institution, we have collected a large number of patient cases for research,” says Hu. “The high volume of data allows us to analyze trends and associations as we examine how thyroid cancer behaves in children, as well as rates of recurrence and persistent disease.”

Current research efforts include:

• Larotrectinib for NTRK fusion DTC. Researchers are evaluating larotrectinib, a highly selective therapy for patients with NTRK fusion-positive thyroid cancers. This non-randomized study may help shift treatment toward molecular characteristics, rather than the tumor’s location.
• Targeted therapy for metastatic DTC. This observational cohort study is examining whether targeted therapies can enhance radioactive iodine (RAI) uptake in thyroid cancer cells, which could allow for lower cumulative doses while maintaining effectiveness. Since pediatric patients often require multiple RAI treatments and face decades of potential radiation effects, reducing total dose while preserving cure rates could significantly affect quality of life.
• Selpercatinib for RET fusion DTC. Scientists are evaluating whether delivering selpercatinib, a targeted therapy, before RAI treatment improves outcomes with thyroid cancer that has a RET genetic mutation. The non-randomized study may show whether the drug can enhance the tumor’s ability to uptake the RAI, thereby requiring lower doses to ablate any disease and leading to fewer complications.

“These trials will shape the future of pediatric thyroid cancer care,” says Rangaswami. “Through comprehensive molecular testing and biobanking, we can identify which patients may benefit from targeted therapies. At the same time, this information contributes to the growing body of knowledge about pediatric thyroid cancer biology.”

UCSF is also a member of the Child and Adolescent Thyroid Consortium (CATC). This partnership combines a registry and a biorepository within a network of leading pediatric institutions, advancing research and treatment for thyroid cancer in children and adolescents. Through this affiliation, UCSF has contributed data on more than 160 cases to the growing registry to compile and analyze trends in pediatric thyroid cancer.

“Participating in the CATC and having leadership roles in the American Thyroid Association give us access to national trials and collaborative research opportunities,” Lodish explains. “We also connect families with opportunities at other consortium sites when needed to ensure they receive the most advanced care.”

Because many pediatric thyroid cancers occur with hereditary cancer syndromes, the clinic works closely with the UCSF Pediatric Hereditary Cancer Clinic. This partnership enables patients with syndromes such as MEN2, PTEN hamartoma syndrome and DICER1 syndrome to receive genetic counseling and surveillance.

Referring patients to the Pediatric Thyroid Cancer Clinic

The clinic welcomes referrals for children and adolescents from across the region with:

• Newly diagnosed thyroid nodules or thyroid cancer
• Recurrent thyroid cancer
• Complex thyroid cancer cases
• Previously treated thyroid cancer requiring ongoing surveillance
• Hereditary cancer syndromes that increase thyroid cancer risk

Patients receive a comprehensive evaluation, multidisciplinary treatment and clinical trial opportunities when appropriate. California residents can access virtual care for follow-up visits.

For referrals or consultations, contact the Pediatric Thyroid Cancer Clinic through the UCSF Benioff Children’s Hospitals referral form. The clinic accommodates urgent consultations within one to two weeks.

The next step in pediatric thyroid cancer care

“Our goal is to cure pediatric thyroid cancer and maximize quality of life for young people with thyroid cancer,” Lodish says. “Precision medicine and collaborative research will help us accomplish this goal.”