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Sorafenib therapy decreases the clearance of thyrotropin

Herman Verloop1, Johannes W A Smit, Olaf M Dekkers

  • 1Department of Endocrinology, C7-99, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.

European Journal of Endocrinology
|November 6, 2012
PubMed
Abstract

Insights

Sorafenib treatment increases thyroid-stimulating hormone (TSH) levels in patients with differentiated thyroid carcinoma. This suggests sorafenib may decrease TSH clearance, impacting thyroid function during cancer therapy.

Area of Science:

  • Endocrinology
  • Oncology
  • Pharmacology

Background:

  • Thyroid dysfunction is a known side effect of tyrosine kinase inhibitors like sorafenib.
  • Potential mechanisms include direct thyroid effects and altered peripheral hormone metabolism.
  • The impact on thyroid-stimulating hormone (TSH) metabolism remains less understood.

Purpose of the Study:

  • To investigate the effect of sorafenib on the peripheral metabolism and clearance of TSH.
  • To determine if sorafenib influences TSH concentrations in patients undergoing treatment.

Main Methods:

  • A study involving 20 athyreotic patients with differentiated thyroid carcinoma on TSH suppression therapy.
  • TSH levels were measured after recombinant human TSH (rhTSH) injections before and after 26 weeks of sorafenib treatment.
  • Key measurements included TSH concentrations at 48 and 96 hours, and the TSH area under the curve (TSH-AUC).

Main Results:

  • Significant increases in TSH(48 h), TSH(96 h), and TSH-AUC were observed after sorafenib therapy.
  • Higher sorafenib doses correlated with greater increases in TSH(96 h) and TSH-AUC.
  • Two patients exhibited TSH levels exceeding 200 mU/l post-sorafenib.

Conclusions:

  • Sorafenib therapy is associated with elevated rhTSH levels, likely due to reduced TSH clearance.
  • Further research is needed to confirm if this decreased TSH clearance is a specific effect of sorafenib.

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