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© The Author 2007. Published by Oxford University Press.
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Hypothyroidism in Patients With Metastatic Renal Cell Carcinoma Treated With Sunitinib
Affiliations of authors: Department of Solid Tumor Oncology, Taussig Cancer Center (BIR, IT, PS, RS, JG, LW, RD, RMB), and Department of Endocrinology, Diabetes, and Metabolism (SR), Cleveland Clinic, Cleveland, OH
Correspondence to: Brian I. Rini, MD, Departments of Solid Tumor Oncology and Urology, Taussig Cancer Center, Cleveland Clinic, 9500 Euclid Ave., Desk R35, Cleveland, OH 44195 (e-mail: rinib2{at}ccf.org).
Sunitinib is an inhibitor of the vascular endothelial growth factor and platelet-derived growth factor receptors, and it has antitumor activity in metastatic renal cell carcinoma and gastrointestinal stromal tumors. To further investigate the fatigue associated with sunitinib therapy, thyroid function tests were performed on patients with metastatic renal cell carcinoma who were receiving sunitinib. Seventy-three patients with metastatic renal cell carcinoma were treated with sunitinib at the Cleveland Clinic Taussig Cancer Center, and 66 of them had thyroid function test results available. Fifty-six (85%) of the 66 patients had one or more abnormality in their thyroid function test results, consistent with hypothyroidism, and 47 (84%) of the 56 patients with abnormal thyroid function tests had signs and/or symptoms possibly related to hypothyroidism. Thyroid hormone replacement was undertaken in 17 patients, and symptoms improved in nine of them. Thyroid function test abnormalities appear to be common in patients with metastatic renal cell carcinoma treated with sunitinib, and routine monitoring is warranted.
| CONTEXT AND CAVEATS Prior knowledge Fatigue was the most common toxic effect in patients with metastatic renal cell carcinoma in trials of sunitinib. Thyroid dysfunction has been associated with anticancer treatment for renal cell carcinoma. Study type Single clinic–based case series. Contribution Sunitinib treatment of patients with metastatic renal cell carcinoma can cause biochemical and clinical thyroid dysfunction. Symptoms improved in some patients after thyroid hormone replacement therapy. Implications Thyroid function test abnormalities are common in patients with metastatic renal cell carcinoma treated with sunitinib, and routine monitoring may be of value. Limitations The number of patients was small and there were no control subjects, so it could not be determined whether thyroid dysfunction was associated with outcome.
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Correspondence about this Article
- Re: Hypothyroidism in Patients With Metastatic Renal Cell Carcinoma Treated With Sunitinib
- David H. Garfield, Aleck Hercbergs, and Paul J. Davis
J Natl Cancer Inst 2007 99: 975-976.[Extract] [Full Text] [PDF]
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