In this video, Dr. Greg Randolph of Harvard Medical School explains how modern neoadjuvant therapies—including lenvatinib and targeted agents for RET-altered and anaplastic thyroid cancers—are transforming the management of advanced differentiated thyroid cancer (DTC). He highlights how these treatments can convert previously inoperable cases into candidates for R0/R1 resection, while also introducing challenges such as peripheral fibrosis and desmoplastic response. Dr. Randolph underscores the importance of close collaboration between surgeons, endocrinologists, and medical oncologists as the treatment landscape continues to evolve.