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[Sunitinib and hypothyroidism].

R Cohen1, H Bihan, B Uzzan

  • 1Université Paris-XIII (CRNH) et service de médecine interne et d'endocrinologie, hôpital Avicenne, APHP, 93009 Bobigny cedex, France. regis.cohen@avc.aphp.fr

Annales D'Endocrinologie
|August 21, 2007
PubMed
Summary
This summary is machine-generated.

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Sunitinib, a tyrosine kinase inhibitor, frequently causes hypothyroidism in patients with metastatic renal carcinomas and GIST. This side effect, potentially linked to anti-thyroid peroxidase activity, warrants regular thyroid screening.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Sunitinib is a multi-targeted tyrosine kinase inhibitor used for metastatic renal cell carcinoma and imatinib-resistant gastrointestinal stromal tumors.
  • Clinical studies indicate a high incidence of hypothyroidism associated with sunitinib treatment, affecting over 50% of patients in some cohorts.
  • Unusual cases of non-visualized thyroid tissue on ultrasonography have been reported in patients receiving sunitinib.

Purpose of the Study:

  • To investigate the association between sunitinib use and thyroid dysfunction.
  • To explore potential mechanisms underlying sunitinib-induced hypothyroidism.
  • To highlight the clinical implications of this adverse effect and its potential connection to antitumor activity.

Main Methods:

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  • Review of prospective and retrospective studies examining sunitinib's side effect profile.
  • Analysis of reported cases of thyroid abnormalities, including ultrasonography findings.
  • Discussion of proposed pathogenetic mechanisms, including destructive thyroiditis and anti-angiogenic effects.

    • Main Results:

    • Hypothyroidism is a common adverse effect of sunitinib, observed in a significant percentage of patients.
    • In rare instances, sunitinib treatment has been associated with the non-visualisation of thyroid tissue on ultrasound.
    • Evidence suggests sunitinib may possess anti-thyroperoxidase activity, contributing to hypothyroidism.

    Conclusions:

    • Regular screening for thyroid abnormalities (every three months) is crucial for patients on sunitinib to manage hypothyroidism and maintain quality of life.
    • The unique thyroid-related side effects of sunitinib, including thyroid tissue non-visualisation, may suggest a potential antitumor effect in thyroid cancer.