Proved that most people with small, low-risk thyroid cancers can skip radioactive iodine after surgery without any increase in recurrence.
ESTIMABL2, trial NCT01837745 sponsored by Gustave Roussy and the French Endocrine Tumour Group and reported in 2022, proved that most people with small, low-risk differentiated thyroid cancers can skip radioactive iodine after total thyroidectomy without any increase in recurrence. It randomised 776 patients with pT1a to T1b, node-negative tumours to no radioiodine or 1.1 GBq ablation and met its non-inferiority endpoint on event-free status at three years, confirmed at five years in 2024. OnCo links it to thyroid cancer, radioiodine therapy, radioactive iodine, the low-risk thyroid cancer term, Gustave Roussy and Martin Schlumberger, and together with IoN and HiLo it removed radioiodine from routine low-risk care in ATA and ESMO guidance; the UK IoN trial reached the same conclusion. Whether the same holds for larger low-risk tumours, as IoN suggested for pT2, is the remaining question.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
776 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Patients without events at 3 yearsprimary | No radioiodine | - | 95.6% | - | - | link |
| Radioiodine 1.1 GBq | - | 95.9% |
Shares Low-risk differentiated thyroid cancer (ATA risk), Radioactive iodine (I-131), Radioiodine therapy and whole-body iodine scanning, Thyroid cancer.
Shares Radioactive iodine (I-131), Radioiodine therapy and whole-body iodine scanning, Thyroid cancer.
Shares Low-risk differentiated thyroid cancer (ATA risk), Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Thyroid cancer.
Shares Radioactive iodine (I-131), Radioiodine therapy and whole-body iodine scanning, Thyroid cancer.
Shares Low-risk differentiated thyroid cancer (ATA risk), Thyroid cancer.
Shares Radioactive iodine (I-131), Radioiodine therapy and whole-body iodine scanning, Thyroid cancer.
Shares Radioactive iodine (I-131), Radioiodine therapy and whole-body iodine scanning, Thyroid cancer.
Shares Martin Schlumberger, Thyroid cancer.