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.
| Original language | English |
|---|---|
| Pages (from-to) | 219-228 |
| Number of pages | 10 |
| Journal | Nature Reviews Clinical Oncology |
| Volume | 6 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2009 |
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ASJC Scopus subject areas
- Oncology
- Medicine(all)
Cite this
Hypothyroidism related to tyrosine kinase inhibitors : An emerging toxic effect of targeted therapy. / Torino, Francesco; Corsello, Salvatore Maria; Longo, Raffaele; Barnabei, Agnese; Gasparini, Giampietro.
In: Nature Reviews Clinical Oncology, Vol. 6, No. 4, 2009, p. 219-228.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hypothyroidism related to tyrosine kinase inhibitors
T2 - An emerging toxic effect of targeted therapy
AU - Torino, Francesco
AU - Corsello, Salvatore Maria
AU - Longo, Raffaele
AU - Barnabei, Agnese
AU - Gasparini, Giampietro
PY - 2009
Y1 - 2009
N2 - 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.
AB - 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.
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U2 - 10.1038/nrclinonc.2009.4
DO - 10.1038/nrclinonc.2009.4
M3 - Article
C2 - 19333228
AN - SCOPUS:67650173972
VL - 6
SP - 219
EP - 228
JO - Nature Reviews Clinical Oncology
JF - Nature Reviews Clinical Oncology
SN - 1759-4774
IS - 4
ER -