致癌酪氨酸激酶 (TK) 是在细胞生长和增殖中发挥关键作用的酶，其突变可导致不受控制的细胞生长和侵袭性癌症的发展。这些知识促进了新型药物酪氨酸激酶抑制剂（TKI）的开发。它们针对与晚期放射性碘 (RAI) 难治性 TC 相关的致癌激酶，这些 TC 无法再吸收 RAI 和/或在 Iodine-131 (I131) 连续治疗期间仍然生长。自从乐伐替尼和索拉非尼获批以来，其他几种人们已经研究了分子抑制剂，然后将其用于治疗侵袭性和难治性甲状腺癌（TC），尽管出现了不良反应或肿瘤抵抗机制，但越来越多的化合物仍在研究中。在 PubMed 和 ClinicalTrials.gov 上进行文献检索，以识别截至 2023 年 12 月发表的相关文章和临床试验。在临床试验的背景下，由特定分子突变的存在或什至在这两种情况都不存在的情况下，全身治疗 TKI是治疗受侵袭性 TC 影响的患者的宝贵武器，等待更有效、更安全的药物进一步扩大治疗范围。

Oncogenic tyrosine kinases (TK) are enzymes that play a key role in cell growth and proliferation and their mutations can lead to uncontrolled cell growth and development of aggressive cancer. This knowledge has led to the development of new classes of drugs, Tyrosine kinase inhibitors (TKI). They target oncogenic kinases who are associated with advanced radioactive iodine (RAI)-refractory TC, which is not able to uptake RAI anymore and/or still grows between consecutive treatments with Iodine-131 (I131).Since Lenvatinib and Sorafenib approval, several other molecular inhibitors have been studied and then introduced for the treatment of aggressive and refractory thyroid cancer (TC), and, although the development of adverse effects or tumor resistance mechanisms, more and more compounds are still under investigation. The literature search was executed in PubMed and ClinicalTrials.gov to identify relevant articles and clinical trials published until December 2023.In the context of clinical trials, driven by the presence of specific molecular mutations or even in the absence of both conditions, systemic therapy TKIs are valuable weapons to be used in patients affected by aggressive forms of TC, waiting for further expansion of the treatment landscape with more efficacious and safer drugs.