The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Sunitinib-induced hypothyroidism

Sunitinib에 의한 갑상선기능저하증

  • Chung, Yun-Jae (Division of Endocrinology, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine)
  • 정윤재 (중앙대학교 의과대학 중앙대학교병원 내분비내과)
  • Published : 2010.11.01
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Abstract

Sunitinib is an oral multi-targeted tyrosine kinase inhibitor that is effective for advanced renal cell carcinoma and imatinib-resistant gastrointestinal stromal tumor. Currently, sunitinib is being investigated in multiple other tumor types including non-small cell lung cancer, breast cancer, colon cancer, and endocrine tumors. Recent studies have shown that sunitinib induces thyroid dysfunction, mainly hypothyroidism during treatment. The incidence of sunitinib-induced hypothyroidism has been reported to be 36~85%. Although several hypotheses have been suggested, the mechanisms by which sunitinib induces hypothyroidism are not clear. As considered the fairly high incidence of sunitinib-induced hypothyroidism, thyroid function should be regularly monitored in all patients treated with sunitinib.

Keywords

References

  1. Chow LQ, Eckhardt SG. Sunitinib: from rational design to clinical efficacy. J Clin Oncol 25:884-896, 2007 https://doi.org/10.1200/JCO.2006.06.3602
  2. Sato S, Muraishi K, Tani J, Sasaki Y, Tokubuchi I, Tajiri Y, Yamada K, Suekane S, Miyajima J, Matsuoka K, Hiromatsu Y. Clinical characteristics of thyroid abnormalities induced by sunitinib treatment in Japanese patients with renal cell carcinoma. Endocr J 2010. [Epub ahead of print]
  3. Desai J, Yassa L, Marqusee E, George S, Frates MC, Chen MH, Morgan JA, Dychter SS, Larsen PR, Demetri GD, Alexander EK. Hypothyroidism after sunitinib treatment for patients with gastrointestinal stromal tumors. Ann Intern Med 145:660-664, 2006 https://doi.org/10.7326/0003-4819-145-9-200611070-00008
  4. Grossmann M, Premaratne E, Desai J, Davis ID. Thyrotoxicosis during sunitinib treatment for renal cell carcinoma. Clin Endocrinol (Oxf) 69:669-672, 2008 https://doi.org/10.1111/j.1365-2265.2008.03253.x
  5. Rogiers A, Wolter P, Op de Beeck K, Thijs M, Decallonne B, Schoffski P. Shrinkage of thyroid volume in sunitinib-treated patients with renal-cell carcinoma: a potential marker of irreversible thyroid dysfunction? Thyroid 20:317-322, 2010 https://doi.org/10.1089/thy.2009.0125
  6. Baffert F, Le T, Sennino B, Thurston G, Kuo CJ, Hu-Lowe D, McDonald DM. Cellular changes in normal blood capillaries undergoing regression after inhibition of VEGF signaling. Am J Physiol Heart Circ Physiol 290:H547-H559, 2006
  7. Salem AK, Fenton MS, Marion KM, Hershman JM. Effect of sunitinib on growth and function of FRTL-5 thyroid cells. Thyroid 18:631-635, 2008 https://doi.org/10.1089/thy.2007.0336
  8. Fenton MS, Marion KM, Salem AK, Hogen R, Naeim F, Hershman JM. Sunitinib inhibits MEK/ERK and SAPK/JNK pathways and increases sodium/iodide symporter expression in papillary thyroid cancer. Thyroid 20:965-974, 2010 https://doi.org/10.1089/thy.2010.0008
  9. Kimura T, Van Keymeulen A, Golstein J, Fusco A, Dumont JE, Roger PP. Regulation of thyroid cell proliferation by TSH and other factors: a critical evaluation of in vitro models. Endocr Rev 22:631-656, 2001 https://doi.org/10.1210/er.22.5.631
  10. Sherman SI. Targeted therapy of thyroid cancer. Biochem Pharmacol 80:592-601, 2010 https://doi.org/10.1016/j.bcp.2010.05.003