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Thyroid dysfunction in patients treated with sunitinib or sorafenib

Julia Clemons1, Dexiang Gao, Mary Naam

  • 1Division of Medical Oncology, Department of Medicine, School of Medicine, University of Colorado Denver, Aurora, USA. julia.clemons@ucdenver.edu

Clinical Genitourinary Cancer
|September 29, 2012
PubMed
Abstract

Insights

Sunitinib and sorafenib, tyrosine kinase inhibitors, can cause hypothyroidism in metastatic renal cell carcinoma patients. Developing hypothyroidism during treatment was linked to longer progression-free survival, particularly with sunitinib.

Area of Science:

  • Oncology
  • Endocrinology
  • Pharmacology

Background:

  • Sunitinib and sorafenib are tyrosine kinase inhibitors (TKIs) used for metastatic renal cell carcinoma (mRCC).
  • Hypothyroidism is a known side effect in a subset of patients treated with these TKIs.
  • Characterizing hypothyroidism development and its impact on survival is crucial for mRCC management.

Purpose of the Study:

  • To characterize the incidence of hypothyroidism in patients treated with sunitinib versus sorafenib.
  • To investigate the association between hypothyroidism development and progression-free survival (PFS) in mRCC patients.

Main Methods:

  • Retrospective chart review of patients treated with sunitinib or sorafenib between 2005 and 2011.
  • Analysis of treatment courses and hypothyroidism development, with separate analysis for pre-existing hypothyroidism.
  • Statistical comparison of hypothyroidism incidence and PFS between treatment groups.

Main Results:

  • Of 73 treatment periods, 44% of sunitinib-treated patients and 27% of sorafenib-treated patients developed hypothyroidism.
  • Sunitinib was associated with a significantly higher incidence of hypothyroidism compared to sorafenib (HR 0.38).
  • Patients developing hypothyroidism had significantly longer PFS (18.2 months) compared to those who did not (10.1 months).

Conclusions:

  • Sunitinib treatment is associated with a higher incidence of hypothyroidism compared to sorafenib in mRCC patients.
  • The development of hypothyroidism during TKI therapy correlates with improved progression-free survival.
  • Monitoring thyroid function and understanding this association can inform treatment strategies for mRCC.

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