LAUSR

The recently published 2021 guidelines for the management of patients with anaplastic thyroid cancer from the American Thyroid Association provide updated recommendations and guidance for the treatment of this rare but lethal thyroid cancer and incorporate significant advances since the initial guidelines were published in 2012. In particular, the focus on prompt cytopathologic and immunohistochemical diagnosis with the identification of potentially actionable genomic/molecular targets affirms the central and key role of pathologists and cytopathologists in not only the diagnosis but also the management of these patients. Genomic information obtained from the tumor now informs therapeutic decisionmaking. Importantly, BRAF/MEK inhibitors can now be considered in tumors with BRAF V600E mutations, and this has changed the landscape of treatment of anaplastic thyroid carcinoma (ATC). This brief commentary will focus on relevant points of interest for cytopathologists. The author panel of 19 included, as before, otolaryngology head and neck surgeons, medical oncologists, radiation oncologists, pathologists, and endocrine surgeons. New to these guidelines was the inclusion of 2 methodologists, 2 patient advocates, and a basic science researcher. All recommendations were established by consensus, and the quality of evidence was decided by the methodologists, not the writing group. Published peer review data were used. The guidelines are the most recent to be published for the management of ATC and add to international guidelines previously published. 5