title: Tyrosine kinase inhibitors induced thyroid dysfunction: a review of its incidence, pathophysiology, clinical relevance, and treatment.
abstract: Tyrosine kinase inhibitors (TKI) belong to a new class of molecular multitargeted anticancer therapy which targets different growth factor receptors and hence attenuates cancer cell survival and growth. Since their introduction as adjunct treatment for renal cell carcinoma and gastrointestinal stromal tumors (GIST), a number of reports have demonstrated that TKI can induce thyroid dysfunction which was especially more common with sunitinib maleate. Many mechanisms with respect to this adverse effect of tyrosine kinase inhibitors have been proposed including their induction of thyroiditis, capillary regression in the thyroid gland, antithyroid peroxidase antibody production, and their ability to decrease iodine uptake by the thyroid gland. Of interest is the observation that TKI-induced thyroid dysfunction may actually be protective as it was shown to improve overall survival, and it was suggested that it may have a prognostic value. Followup on thyroid function tests while patients are maintained on tyrosine kinase inhibitor is strongly recommended. When thyroid dysfunction occurs, appropriate treatment should be individualized depending on patients symptoms and thyroid stimulating hormone level.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, American University of Beirut-Medical Center, Riad El-Solh, P.O. Box 11-0236, Beirut, Lebanon.
authors.forename: Hala
authors.initials: H
authors.lastname: Ahmadieh
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Salti
mesh_terms: D000818:Animals; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D013961:Thyroid Gland / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D013966:Thyroiditis / Q000139:chemically induced / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology
chemical_list: D047428:Protein Kinase Inhibitors