Abnormalities of thyroid function in Japanese patients with metastatic renal cell carcinoma treated with sorafenib: A prospective evaluation
Abstract
The objective of this study was to characterize features of thyroid dysfunction in Japanese patients with metastatic renal cell carcinoma (RCC) who were treated with sorafenib. We performed a prospective observational study including 69 Japanese patients who were diagnosed as having metastatic RCC refractory to cytokine therapy and subsequently treated with sorafenib for at least 12 weeks. Thyroid function was assessed before and every 4 weeks after the initiation of sorafenib treatment. Of the 69 patients, 23 (33.3%) did not show any biochemical thyroid abnormality, while the remaining 46 (67.7%) developed hypothyroidism. However, 11 (23.9%) of these 46 hypothyroid patients initially had a suppressed thyroid-stimulating hormone (TSH) value accompanying the increase in free triiodothyronine (T3) and/or free thyroxine (T4) before developing hypothyroidism, suggesting sorafenib-induced thyroiditis. During the observation period of this study, 4 patients (5.8%) demonstrated severe clinical symptoms caused by hypothyroidism and received thyroid hormone replacement. Among several factors examined, only age was significantly associated with the risk for hypothyroidism. These findings suggest that although the incidence of clinically significant hypothyroidism requiring thyroid hormone replacement therapy was not very high, biochemical thyroid abnormality was frequently observed in Japanese RCC patients treated with sorafenib. Accordingly, regular surveillance of thyroid function by the measurement of TSH, free T3, and T4 is warranted during sorafenib treatment in Japanese RCC patients.
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The tyrosine kinase inhibitors sunitinib, sorafenib, and nilotinib have each been associated with a transient thyrotoxicosis due to destructive thyroiditis.
“The tyrosine kinase inhibitors sunitinib (642-647), sorafenib (648-650), and nilotinib (651) have each been associated with a transient thyrotoxicosis due to destructive thyroiditis.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [649]
One study of 69 patients treated with sorafenib for metastatic renal cell carcinoma found that 11 (16%) developed transient thyroiditis followed by hypothyroidism.
“One study of 69 patients treated with sorafenib for metastatic renal cell carcinoma found that 11 (16%) developed transient thyroiditis followed by hypothyroidism (649).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [649]
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“One study of 69 patients treated with sorafenib for metastatic renal cell carcinoma found that 11 (16%) developed transient thyroiditis followed by hypothyroidism (649).”
BackgroundThyroid Dysfunction as an Unintended Side Effect of Anticancer Drugs
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Thyroid dysfunctions induced by tyrosine kinase inhibitors
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Lee, N., Lee, J. L., & Lee, J.-Y. (2023) · Targeted Oncology · doi:10.1007/s11523-023-00951-z · Cited by 20 · see citing works
- Authors
- Miyake, H., Kurahashi, T., Yamanaka, K., Kondo, Y., Muramaki, M., Takenaka, A., Inoue, T.-A., & Fujisawa, M.
- Affiliations
- Kobe University (JP)
- Hyogo Prefectural Cancer Center (JP)
- Corresponding author
- Miyake, Hideaki
- Venue
- Urologic Oncology: Seminars and Original Investigations
- Publisher
- Elsevier BV
- Published
- 2010-09
- Volume
- 28
- Issue
- 5
- Pages
- 515-519
- ISSN
- 1078-1439 (ISSN-L)
- OpenAlex
- W2040339694
- Cited by
- 54
- References
- 18
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 2 · 2016: 4 · 2015: 2 · 2014: 5 · 2013: 5 · 2012: 10
- FWCI
- 6.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Urologic Oncology Seminars and Original Investigations (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal cell carcinoma treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- sorafenib, metastatic renal cell carcinoma, hypothyroidism, thyroid dysfunction, thyroid-stimulating hormone, free triiodothyronine, free thyroxine, drug-induced thyroiditis, thyroid hormone replacement, Japanese patients, age as risk factor, thyroid function monitoring
- MeSH terms
- Sorafenib, Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Benzenesulfonates, Carcinoma, Renal Cell, Female, Humans, Hypothyroidism, Kidney Neoplasms, Male, Middle Aged, Neoplasm Metastasis, Niacinamide, Phenylurea Compounds, Prospective Studies, Pyridines, Thyrotropin, Protein Kinase Inhibitors
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