Document Detail


Clinical characteristics of thyroid abnormalities induced by sunitinib treatment in Japanese patients with renal cell carcinoma.
MedLine Citation:
PMID:  20733268     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sunitinib is a multi-targeted tyrosine kinase inhibitor that is effective for advanced renal cell carcinoma. However, sunitinib often causes hypothyroidism. In this study, we report eight cases with thyroid dysfunction that occurred during sunitinib treatment for advanced renal cell carcinoma. In seven cases, mild hypothyroidism developed early in the first treatment cycle, and recovered spontaneously. Transient hyperthyroidism was observed during the second or third treatment cycles and was preceded by a rapid increase in thyroglobulin levels. (99m)Tc scintigraphy in the hyperthyroid state showed decreased thyroidal uptake of (99m)TcO(4)(-), suggesting destructive thyroiditis. Hypothyroidism subsequently developed, requiring levothyroxine replacement therapy. Ultrasonography showed a hypoechogenic pattern of the parenchyma and decreased intrathyroidal blood flow. The thyroid glands ultimately became atrophic, which may progress to permanent hypothyroidism. These findings suggest that sunitinib-induced hypothyroidism may occur frequently and may be a consequence of thyroiditis with transient thyrotoxicosis. The marked decrease in thyroid size due to reduced capillary blood flow induced by VEGF receptor inhibition may cause delayed and/or permanent hypothyroidism. Therefore, thyroid function should be monitored in all patients treated with sunitinib.
Authors:
Shuichi Sato; Kazuhisa Muraishi; Junichi Tani; Yuko Sasaki; Ichiro Tokubuchi; Yuji Tajiri; Kentaro Yamada; Shigetaka Suekane; Jiro Miyajima; Kei Matsuoka; Yuji Hiromatsu
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-08-21
Journal Detail:
Title:  Endocrine journal     Volume:  57     ISSN:  1348-4540     ISO Abbreviation:  Endocr. J.     Publication Date:  2010  
Date Detail:
Created Date:  2010-11-04     Completed Date:  2011-03-03     Revised Date:  2011-06-16    
Medline Journal Info:
Nlm Unique ID:  9313485     Medline TA:  Endocr J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  873-80     Citation Subset:  IM    
Affiliation:
Division of Endocrinology and Metabolism, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan. dem_sato@med.kurume-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Agents / adverse effects*,  therapeutic use
Atrophy
Carcinoma, Renal Cell / drug therapy*
Disease Progression
Female
Humans
Hyperthyroidism / chemically induced,  pathology,  physiopathology
Hypothyroidism / chemically induced*,  pathology
Indoles / adverse effects*,  therapeutic use
Japan
Male
Middle Aged
Organ Size / drug effects
Protein Kinase Inhibitors / adverse effects,  therapeutic use
Pyrroles / adverse effects*,  therapeutic use
Regional Blood Flow / drug effects
Thyroid Gland / blood supply,  drug effects*,  pathology
Thyroiditis / chemically induced
Thyrotoxicosis / chemically induced,  pathology,  physiopathology
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Indoles; 0/Protein Kinase Inhibitors; 0/Pyrroles; 0/sunitinib

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