title: Does sunitinib-induced hypothyroidism play a role in the activity of sunitinib in metastatic renal cell carcinoma?
abstract: BACKGROUND
  The objective of this study was to evaluate if hypothyroidism developing during sunitib therapy in patients with metastatic renal cell carcinoma (mRCC) is associated with a better outcome.
  
  
  METHODS
  Thirty-one consecutive patients with clear cell mRCC were retrospectively analyzed. Thyroid function was assessed prior to therapy, every 6 weeks during the first 6 months and every 2-4 months thereafter. Hypothyroidism was considered present if thyroid-stimulating hormone (TSH) exceeded the upper normal limit (UNL) with normal triiodothyronine (T3) and thyroxine (T4).
  
  
  RESULTS
  Hypothyroidism occurred in 16 patients (52%) within 3 months (range 0.7-22.9) of treatment initiation. Thyroid replacement corrected TSH below the UNL in 10 patients (63%). The distribution according to Motzer prognostic criteria revealed good prognosis in 16 patients (52%), intermediate in 9 (29%) and poor in 6 (19%). The hypothyroid patients tended to have longer progression-free survival (PFS; median 12.2 vs. 9.4 months; p = 0.234) and longer survival (median 22.4 vs. 13.9 months; p = 0.234) than the euthyroid patients. Clinical benefits were similar in both groups.
  
  
  CONCLUSIONS
  Hypothyroidism that develops in mRCC patients treated with sunitinib is associated with a trend toward prolonged PFS and survival, with a similar clinical benefit rate.
authors: Department of Oncology, Assaf Harofeh Medical Center, Zerifin, Israel. a_sella@asaf.health.gov.il
authors: Avishay
authors: A
authors: Sella
authors: Aleck H
authors: AH
authors: Hercbergs
authors: Ekaterina
authors: E
authors: Hanovich
authors: Svetlana
authors: S
authors: Kovel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality; D018572:Disease-Free Survival; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced* / Q000378:metabolism; D007211:Indoles / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009392:Nephrectomy; D011379:Prognosis; D011758:Pyrroles / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077210:Sunitinib; D013961:Thyroid Gland / Q000187:drug effects; D013972:Thyrotropin / Q000032:analysis; D013974:Thyroxine / Q000032:analysis; D014284:Triiodothyronine / Q000032:analysis
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine; D000077210:Sunitinib