Hypothyroidism related to tyrosine kinase inhibitors: an emerging toxic effect of targeted therapy

Salvatore Maria Corsello, F Torino, R Longo, A Barnabei, G. Gasparini

Risultato della ricerca: Contributo in rivistaArticolo in rivista

139 Citazioni (Scopus)

Abstract

Despite their inherent selectivity, targeted therapies such as tyrosine kinase inhibitors (TKIs) can cause unusual adverse effects. Sunitinib and sorafenib are multitargeted TKIs that have been demonstrated to induce hypothyroidism and thyroid dysfunction. Retrospective studies indicate that sunitinib can induce hypothyroidism in 53-85% of patients, and in prospective studies this complication has been reported in 36-71% of patients. Sorafenib has been reported to be responsible for hypothyroidism in 18% of patients with metastatic renal-cell carcinoma. Furthermore, imatinib and sunitinib seem to increase the requirement of levothyroxine in hypothyroid patients. The management of thyroid dysfunction and possible related symptoms, such as fatigue, represents a challenge to oncologists. We propose a diagnostic and therapeutic algorithm for the management of TKI-related hypothyroidism. Prospective trials are needed to define the incidence of overt and subclinical hypothyroidism and thyroid dysfunction during therapy with sunitinib, sorafenib and potentially other TKIs. The safety and efficacy, and optimal dosing and timing of starting replacement therapy in patients affected by TKI-related hypothyroidism need accurate appraisal and should be evaluated prospectively in appropriately designed trials.
Lingua originaleEnglish
pagine (da-a)219-228
Numero di pagine10
RivistaNATURE REVIEWS. CLINICAL ONCOLOGY
Volume6
DOI
Stato di pubblicazionePubblicato - 2009

Keywords

  • Antineoplastic Agents
  • Benzenesulfonates
  • Drug Therapy, Combination
  • Humans
  • Hypothyroidism
  • Indoles
  • Neoplasms
  • Protein Kinase Inhibitors
  • Pyridines
  • Pyrroles
  • Risk Assessment
  • Thyroid Function Tests
  • Treatment Outcome

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