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The clinical implications of sunitinib-induced hypothyroidism: a prospective evaluation

P Wolter1, C Stefan, B Decallonne

  • 1Department of General Medical Oncology, University Hospital Gasthuisberg, Catholic University Leuven, Leuven Cancer Institute, Herestraat 49, Leuven B-3000, Belgium. Pascal.Wolter@uz.kuleuven.be

British Journal of Cancer
|July 31, 2008
PubMed

Insights

Sunitinib treatment for renal cell carcinoma and gastrointestinal stromal tumors can cause hypothyroidism. Close thyroid function monitoring is essential for patients receiving sunitinib therapy.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Sunitinib is a targeted therapy used for metastatic renal cell carcinoma (RCC) and imatinib-resistant gastrointestinal stromal tumors (GIST).
  • Previous research indicates a notable incidence of thyroid dysfunction associated with sunitinib treatment.

Purpose of the Study:

  • To prospectively evaluate the incidence and severity of hypothyroidism in patients with RCC or GIST undergoing sunitinib therapy.
  • To define the clinical impact of sunitinib on thyroid function and establish monitoring guidelines.

Main Methods:

  • A prospective observational study was conducted.
  • Thyroid function tests (thyroid-stimulating hormone) were performed at baseline and during each treatment cycle (days 1 and 28).
  • Thyroid antibodies were assessed at baseline and during follow-up for patients with abnormal thyroid function.

Main Results:

  • 27% of patients developed subclinical or overt hypothyroidism requiring hormone replacement.
  • 34% exhibited elevated thyroid-stimulating hormone levels not necessitating intervention.
  • 34% of patients did not experience any biochemical thyroid abnormalities.

Conclusions:

  • Sunitinib therapy is associated with the induction of (sub)clinical hypothyroidism in a significant proportion of patients.
  • Regular monitoring of thyroid function is crucial for patients receiving sunitinib.
  • An algorithm for managing sunitinib-induced hypothyroidism in clinical practice is proposed.

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