Hypothyroidism during treatment with tyrosine kinase inhibitors

Endokrynol Pol. 2012;63(4):302-6.

Abstract

Tyrosine kinase inhibitors are relatively new targeted therapy drugs used for the treatment of metastatic clear cell kidney carcinoma, gastrointestinal stromal tumours, thyroid carcinoma and pancreatic neuroendocrine tumours during the progression of the disease. Hypothyroidism or thyroid dysfunction is often a side effect of this treatment. Therefore, monitoring of thyroid hormone levels before the beginning and during the treatment of tyrosine kinase inhibitors is a necessity. Hypothyroidism correlates with objective response to the treatment. Sunitinib. This is the most described tyrosine kinase inhibitor which causes hypothyroidism. The mechanism of hypothyroidism is still unclear. Sorafenib. Symptoms of hypothyroidism occur in 18% of patients treated with sorafenib due to metastatic renal cell carcinoma. Imatinib. Hypothyroidism is one of the most frequent side effects of the treatment. Emergent tracheotomy was necessary due to larynx swelling during marked hypothyroidism. Motesanib. Hypothyroidism or increased TSH level is diagnosed in 22% to 69% of patients with metastatic differentiated or medullary thyroid carcinomas. The management of patients with thyroid dysfunction and related symptoms such as fatigue is undoubtedly a challenge to an oncologist.

Publication types

  • Review

MeSH terms

  • Carcinoma, Renal Cell / drug therapy
  • Dose-Response Relationship, Drug
  • Gastrointestinal Neoplasms / drug therapy
  • Humans
  • Indoles / administration & dosage
  • Indoles / adverse effects*
  • Kidney Neoplasms / drug therapy
  • Liver Neoplasms / drug therapy
  • Neoplasm Metastasis
  • Neoplasms / drug therapy*
  • Neoplasms / pathology
  • Niacinamide / administration & dosage
  • Niacinamide / adverse effects
  • Niacinamide / analogs & derivatives*
  • Phenylurea Compounds / administration & dosage
  • Phenylurea Compounds / adverse effects*
  • Pyrroles / administration & dosage
  • Pyrroles / adverse effects*
  • Sorafenib
  • Sunitinib
  • Thyroid Diseases / chemically induced*
  • Thyroid Diseases / prevention & control
  • Thyroid Function Tests
  • Thyroid Gland / drug effects
  • Thyroid Neoplasms / drug therapy

Substances

  • Indoles
  • Phenylurea Compounds
  • Pyrroles
  • Niacinamide
  • Sorafenib
  • Sunitinib