{"entity":{"id":"rai-refractory","kind":"term","name":"Radioiodine-refractory (RAI-R) thyroid cancer","aka":[],"tldr":"Thyroid cancer that no longer takes up radioactive iodine, or keeps growing despite it. This is when kinase inhibitor pills come in.","summary":"Defined by absence of uptake on a diagnostic scan, progression within 12 months of treatment, or cumulative activity >22.2 GBq (600 mCi) without control. Affects ~5-15% of differentiated thyroid cancers, often with BRAF V600E or TERT promoter mutations. Median survival historically 3-5 years; lenvatinib, sorafenib, and genotype-directed drugs (RET, NTRK, BRAF) apply.","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Thyroid_cancer","links":[{"label":"ClinicalTrials.gov NCT01321554: SELECT","url":"https://clinicaltrials.gov/study/NCT01321554"},{"label":"ClinicalTrials.gov NCT00984282: DECISION","url":"https://clinicaltrials.gov/study/NCT00984282"}],"tags":[],"related":[],"cancers":["thyroid"],"sections":[],"technologies":["radioiodine-therapy"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["select-lenvatinib","decision-sorafenib"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Clinical"},"route":"/terms/rai-refractory/","neighbours":{"cancer":[{"id":"follicular-thyroid-cancer","kind":"cancer","name":"Follicular thyroid cancer","route":"/cancers/follicular-thyroid-cancer/"},{"id":"papillary-thyroid-cancer","kind":"cancer","name":"Papillary thyroid cancer","route":"/cancers/papillary-thyroid-cancer/"},{"id":"thyroid","kind":"cancer","name":"Thyroid cancer","route":"/cancers/thyroid/"}],"technology":[{"id":"radioiodine-therapy","kind":"technology","name":"Radioiodine therapy and whole-body iodine scanning","route":"/technologies/radioiodine-therapy/"}],"trial":[{"id":"decision-sorafenib","kind":"trial","name":"DECISION","route":"/trials/decision-sorafenib/"},{"id":"select-lenvatinib","kind":"trial","name":"SELECT","route":"/trials/select-lenvatinib/"}],"drug":[{"id":"radioactive-iodine","kind":"drug","name":"Radioactive iodine (I-131)","route":"/drugs/radioactive-iodine/"}],"pairing":[{"id":"redifferentiation-rai","kind":"pairing","name":"MAPK inhibitor redifferentiation → radioiodine","route":"/pairings/redifferentiation-rai/"}]}}