对于晚期分化甲状腺癌的伦瓦替尼治疗对皮质醇缺乏症的影响
Salvatore Monti1, Beatrice Fazzalari1, Valerio Renzelli1
1Endocrinology and Diabetes Unit, Azienda Ospedaliero-Universitaria Sant'Andrea, ''Sapienza'' University, Rome, Italy.
Frontiers in endocrinology
|January 21, 2026
概括
治疗甲状腺癌的伦瓦提尼布经常导致一次性上腺功能不全 (PAI),这种情况与患者的疲劳有关. 早期检测和类固醇替代疗法可以改善治疗耐受性和坚持性.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 伦瓦提尼布对抗放射性分化甲状腺癌 (RR-DTC) 有效,但会引起副作用.
- 主要上腺功能缺陷 (PAI) 是Lenvatinib的一个未被认可的副作用.
- PAI可能会导致疲劳,这是伦瓦替尼治疗中常见的一种不良事件.
研究的目的:
- 调查在接受伦瓦替尼治疗的RR-DTC患者中PAI的发生率,发展和时间过程.
- 为了评估PAI和疲劳在伦瓦丁尼布治疗期间的关系.
- 评估葡萄糖皮质醇替代疗法对PAI和疲劳的影响.
主要方法:
- 对31名RR-DTC患者进行前性研究,这些患者接受了伦瓦提尼布治疗.
- 通过ACTH刺激测试评估上腺功能,测量血清皮质醇和ACTH.
- 使用CTCAE分级评估疲劳;PAI诊断的皮质醇水平高峰低于定义的值 (PAI-18.1和PAI-14).
主要成果:
- 观察到PAI的高发病率:77.4%发展为PAI-18.1和45.2%发展为PAI-14.
- 伦瓦提尼布前较低的基线皮质醇水平预测了患上PAI的风险更高.
- 在开始酸皮质 (CA) 治疗后,在PAI患者中注意到疲劳的显著改善.
结论:
- 在Lenvatinib治疗的RR-DTC患者中,PAI是常见的,可能会导致疲劳.
- 常规的上腺功能测试和及时的PAI诊断至关重要.
- 有效的皮质糖类替代剂可提高伦瓦替尼的耐受性和患者的坚持性.
相关概念视频
Treatment Resistant Cancers
3.7K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.7K
The Thyroid Gland
6.8K
The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
6.8K
Functions of Thyroid Hormones
5.0K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
5.0K
Extraction: Advanced Methods
1.1K
Metal ions can be separated from one another by complexation with organic ligands–the chelating agent– to form uncharged chelates. Here, the chelating agent must contain hydrophobic groups and behave as a weak acid, losing a proton to bind with the metal. Since most organic ligands used in this process are insoluble or undergo oxidation in the aqueous phase, the chelating agent is initially added to the organic phase and extracted into the aqueous phase. The metal-ligand complex is...
1.1K
Synthesis and Regulation of Thyroid Hormones
7.3K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
7.3K
Overview of Advanced Functional Groups
29.2K
Functional groups are groups of atoms with specific chemical properties that occur within organic molecules and are sometimes denoted as “R”. Functional groups can “functionalize” a compound by enabling it to adopt different physical and chemical properties.
Types of Advanced Functional Groups
The table below summarizes some of the major functional groups in organic chemistry.
29.2K


