title: Thyroid dysfunction in patients treated with sunitinib or sorafenib.
abstract: BACKGROUND
  Sunitinib and sorafenib are tyrosine kinase inhibitors used in metastatic renal cell carcinoma and are known to cause hypothyroidism in a subset of patients. The goal of this study was to better characterize the development of hypothyroidism in patients and to examine its relationship to progression-free survival.
  
  
  METHODS
  A retrospective chart review was performed on patients treated with sunitinib or sorafenib from January 1, 2005, to January 1, 2011. Data pertaining to the treatment course and development of hypothyroidism were extracted. Patients with hypothyroidism at the beginning of treatment were analyzed separately.
  
  
  RESULTS
  A total of 73 treatment periods had sufficient data to analyze. Among patients with normal baseline thyroid function, 15 (44%) of 34 patients treated with sunitinib and 6 (27%) of 22 patients treated with sorafenib developed hypothyroidism. The hazard ratio for the development of hypothyroidism with sorafenib vs. sunitinib treatment was significant, at 0.38 (95% CI, 0.14-0.97). There was a statistically significant difference in the progression-free survival between patients who developed hypothyroidism while receiving treatment compared with those who did not, 18.2 vs. 10.1 months (P = .01).
  
  
  CONCLUSIONS
  This study demonstrated a significant difference in the incidence of hypothyroidism during treatment with sunitinib and sorafenib, with a higher incidence of hypothyroidism in patients treated with sunitinib. The development of hypothyroidism was associated with a longer progression-free survival.
authors.affiliation: Division of Medical Oncology, Department of Medicine, School of Medicine, University of Colorado Denver, Aurora, USA. julia.clemons@ucdenver.edu
authors.forename: Julia
authors.initials: J
authors.lastname: Clemons
authors.forename: Dexiang
authors.initials: D
authors.lastname: Gao
authors.forename: Mary
authors.initials: M
authors.lastname: Naam
authors.forename: Kathryn
authors.initials: K
authors.lastname: Breaker
authors.forename: David
authors.initials: D
authors.lastname: Garfield
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Flaig
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced* / Q000188:drug therapy; D007211:Indoles / Q000009:adverse effects*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives*; D010671:Phenylurea Compounds / Q000009:adverse effects*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011758:Pyrroles / Q000009:adverse effects*; D012189:Retrospective Studies; D000077157:Sorafenib; D000077210:Sunitinib; D013961:Thyroid Gland / Q000187:drug effects / Q000503:physiopathology; D013963:Thyroid Hormones / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D011758:Pyrroles; D013963:Thyroid Hormones; D009536:Niacinamide; D000077157:Sorafenib; D000077210:Sunitinib