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Treatment with Sunitinib and Hypothyroidism – a Case Report and Overview of Literature


Authors: A. Kreze jr. 1;  V. Stáhalová 2;  A. Zadražilová 1;  J. Koskuba 1;  M. Kosák 1
Authors place of work: II. interní oddělení, FN Na Bulovce, Praha 2Ústav radiační onkologie, Praha 1
Published in the journal: Klin Onkol 2009; 22(4): 176-178
Category: Case Reports

Summary

In the article the authors present the case of a patient with clear cell renal carcinoma, where after nephrectomy local metastases appeared. The treatment of choice was sunitinib. After 20 cycles of therapy heavy hypothyroidism was verified which required substitution by thyroxine. Elevated levels of TSH appeared in up to 70% and hypothyrodism in up to 40% of thus treated patients. Also described is the mechanism of action of sunitinib. There seems to exist a correlation between the „adverse effects” of the drug and a better result of the therapy of cancer, however, prospective studies are absent. Most experts agree that the thyroid function during treatment with sunitinib needs to be monitored.

Key words:
sunitinib – hypothyroidism – renal carcinoma


Zdroje

1. Goodman VL, Rock EP, Dagher R et al. Approved summary: sunitinib for the treatment of imantinib refractory or intolerant gastrointestinal stromal tumors and advanced renal carcinoma. Clin Cancer Res 2007; 13(5): 1367–1373.

2. Bergman L, Hariharan S, Weingang-Kohler K et al. Safety and efficacy of sunitinib in metastatic renal cell carcinoma (mRCC) patients (pts) with brain metastases ( mets): results of an expanded-access study. Onkologie 2008; 31 (Suppl 4): 233–234.

3. Chow LQ, Eckhard SG. Sunitinib: from rational design to clinical efficacy. J Clin Oncol 2007; 25(19): 2858–2859.

4. Motzer RJ, Huston TE, Tomczak P et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. NEJM 2007; 356(2): 115–124.

5. Rini BI. Response: Re: Hypothyroidism in patients with metastatic renal cell carcinoma treated with sunitinib. JNCI 2007; 99(12): 976–977.

6. Wong E, Rosen LS, Mulay M et al. Sunitinib induces hypothyroidism in advanced cancer patients and may inhibit thyroid peroxidase activity. Thyroid 2007; 17(4): 351–355.

7. Garfield DH, Wolter P, Schofinski P et al. Correspondence: Documentation of thyroid function in clinical studies with sunitinib: why does it matter. J Clin Oncol 2008; 26(31): 5131–5132.

8. Mannavola D, Coco P, Vannucchi G et al. A novel tyrosin kinase selective inhibitor, sunitinib, induces transient hypothyroidism by blocking iodine uptake. JCEM 2007; 92(9): 3531–3534.

9. Defuentes G, Bladé JS, Berets O. Tyrosine kinase inhibitors for chronic myelogenous leukemia. NEJM 2007; 357(15): 1556–1557.

10. Garfield DH, Hercbergs A, Davis PJ. Re: Hypothyroidism in patients with metastatic renal cell carcinoma treated with sunitinib. JNCI 2007; 99(12): 975–976.

Štítky
Paediatric clinical oncology Surgery Clinical oncology

Článok vyšiel v časopise

Clinical Oncology

Číslo 4

2009 Číslo 4
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