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Pulmonary cavitation in patients with thyroid cancer receiving antiangiogenic agents
Saumil Datar1, Maria Cabanillas2, Ramona Dadu3
1Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Background:
Thyroid malignancies are among the most common endocrine cancers worldwide. Owing to the angiogenic nature of these malignancies, tyrosine kinase inhibitors (TKIs) are an attractive potential treatment. However, TKIs have been associated with an increased risk of tumor cavitation, in turn linked to poor outcomes, in patients with malignancies in the lungs, where thyroid cancer commonly metastasizes.
Method:
We performe d a retrospective cohort study of patients with thyroid cancer and evidence of metastatic disease to the lung that were treated with multi-targeted antiangiogenic TKIs. The primary objective of this study was to determine the incidence of pulmonary cavitation. The secondary objective was to evaluate the effect of pulmonary cavitation on survival.
Results:
Of the 83 patients with pulmonary nodules, 10 developed cavitation during treatment. Of these 83 patients, two patients had to stop the treatment due to pneumothorax. Additionally, cavitation did not demonstrate any significant effect on survival.
Conclusion:
In patients with thyroid cancer and evidence of metastatic disease to the chest, the use of multi-targeted TKIs led to cavitations that were not uncommon but clinical consequences were marginal. Treatment was stopped only in two patients that developed pneumothorax, however the small sample is a strong limitation of our study.
Insights
Thyroid cancer patients treated with tyrosine kinase inhibitors (TKIs) may develop lung cavitation. This study found cavitation occurred in some patients but did not significantly impact survival outcomes.
Area of Science:
- Oncology
- Endocrinology
- Pulmonary Medicine
Background:
- Thyroid malignancies are common endocrine cancers globally.
- Antiangiogenic tyrosine kinase inhibitors (TKIs) are investigated for thyroid cancer due to its angiogenic nature.
- TKIs may increase tumor cavitation risk, particularly in lung metastases, potentially worsening outcomes.
Purpose of the Study:
- To determine the incidence of pulmonary cavitation in thyroid cancer patients with lung metastases treated with TKIs.
- To evaluate the impact of pulmonary cavitation on patient survival.
Main Methods:
- Retrospective cohort study design.
- Inclusion of patients with thyroid cancer and lung metastases treated with multi-targeted antiangiogenic TKIs.
- Analysis of pulmonary cavitation incidence and its effect on survival.
Main Results:
- Pulmonary cavitation developed in 10 out of 83 patients (12%) during TKI treatment.
- Two patients discontinued treatment due to pneumothorax.
- Pulmonary cavitation did not show a significant effect on overall survival.
Conclusions:
- Multi-targeted TKIs can cause pulmonary cavitation in thyroid cancer patients with lung metastases.
- Observed cavitations had marginal clinical consequences, with limited impact on survival in this cohort.
- The small sample size is a significant limitation, necessitating further research.
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