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Hypothyroidism as a predictive clinical marker of better treatment response to sunitinib therapy

Davor Kust1, Marin Prpić2, Jure Murgić2

  • 1Department of Oncology and Nuclear Medicine, University Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia davor.kust@kbcsm.hr.

Anticancer Research
|June 13, 2014
PubMed
Abstract

Insights

Hypothyroidism is a common side effect of sunitinib in metastatic renal cell carcinoma (mRCC) patients. Patients with hypothyroidism on levothyroxine showed significantly longer progression-free survival (PFS).

Area of Science:

  • Oncology
  • Pharmacology
  • Endocrinology

Background:

  • Tyrosine kinase inhibitors (TKIs) are standard treatment for metastatic renal cell carcinoma (mRCC).
  • Treatment-related hypothyroidism may serve as a predictive biomarker for TKI efficacy.
  • Sunitinib is a commonly used TKI for mRCC.

Purpose of the Study:

  • To investigate the incidence of hypothyroidism in mRCC patients treated with sunitinib.
  • To evaluate the association between hypothyroidism and treatment outcomes, including progression-free survival (PFS) and overall survival (OS).

Main Methods:

  • Retrospective analysis of mRCC patients treated with first-line sunitinib.
  • Thyroid function (TSH levels) assessed every 2 cycles.
  • Prognostic factors analyzed using Cox proportional hazards model.

Main Results:

  • 29.3% of patients developed hypothyroidism during sunitinib treatment.
  • Median peak TSH levels were 34.4 mIU/L.
  • Patients with TSH >4 mIU/L on levothyroxine had significantly prolonged PFS (25.3 months vs. 9.0 months; p=0.042).

Conclusions:

  • Hypothyroidism is a significant side effect of sunitinib in mRCC.
  • Symptomatic hypothyroidism correlated with longer PFS but not OS.
  • Thyroid function monitoring and management may be important in mRCC patients on sunitinib.
Keywords:
Clinical markershypothyroidismlevothyroxine substitution therapypredictive factorrenal cell carcinomasunitinib

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