Apatinib, a novel tyrosine kinase inhibitor that has highly selective competition in the ATP binding site of VEGFR-2, blocks down pathways and inhibits tumor angiogenesis.[14,15] Moreover, overwhelming efficacy has been achieved in radioiodine-refractory differentiated thyroid cancer.[16] All the above evidence favored apatinib as an ideal choice for our patient. The gene discussed is KDR; the disease is differentiated thyroid carcinoma.