For unresectable-appearing BRAF V600E papillary thyroid cancer involving the trachea and carotid artery, is neoadjuvant targeted therapy a viable path to surgery, or is definitive radiation the better option?  

If the tumor is considered not resectable due to carotid encasement, as likely in this case, then neoadjuvant targeted therapies should be not be considered. Multikinase inhibitors (i.e. lenvatinib) or targeted therapies (dabrafenib and trametinib) will not produce great enough responses to make th...