六、免疫治疗
免疫治疗被誉为继手术、放射治疗、化学治疗三大常规疗法后的第4种肿瘤治疗方法，其利用患者免疫系统的特异性和高效性来杀灭机体内的肿瘤。甲状腺癌的微环境具有大量的免疫细胞，所以免疫治疗是其合理的选择[52]。虽然免疫治疗在临床试验中开展较少，但仍获得了一些令人期待的成果。
Schott等[53]和Bachleitnerhofmann等[54]分别发表了他们对各自MTC患者队列使用树突细胞（Dendritic Cell， DC）疫苗进行免疫治疗的随访调查，两者DC疫苗制作方法不同但结果都显示出令人期待的临床前景。潘布陆利珠单抗（Pembrolizumab）作为PD1抑制剂应用于22名DTC患者队列的单药治疗临床实验中，目前报告显示组内患者部分缓解2例，病情稳定12例，18名患者产生治疗相关副作用，没有患者因治疗不良反应而停药或死亡[55]。
随着对甲状腺癌特异性免疫应答发生机制的深入研究，免疫疗法在甲状腺癌的预防、诊断及治疗中将会具有更好的应用前景。但甲状腺相关激素对甲状腺癌患者免疫反应的影响仍有待进一步研究。
目前靶向治疗药物对患者病情的改善仍不甚理想，并且这些药物还具有一些不良反应以及少数病例报道的耐药性和逃逸机制，因此难治性甲状腺癌的临床治疗仍有待研究。随着甲状腺癌分子机制的研究、靶向治疗药物的开发、治疗手段的发展以及个体化的基因检测，将会在未来更有针对性地指导个体进行甲状腺癌靶向药物治疗、核素靶向治疗以及免疫治疗，为患者带来更多益处。
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