title: Thyroid dysfunctions induced by tyrosine kinase inhibitors.
abstract: BACKGROUND
  Recently, tyrosine kinase inhibitors (TKIs) have emerged as a new class of anticancer therapy. Although generally considered less toxic than cytotoxic chemotherapy, TKIs do cause significant side effects including fatigue and hypertension. In addition, thyroid dysfunction is a well-known adverse effect of TKI.
  
  
  METHODS
  This review provides a comprehensive assessment of TKI-induced thyroid dysfunctions by sunitinib, sorafenib, pazopanib, imatinib, dasatinib, nilotinib, vandetanib, axitinib, motesanib and tivozanib. Furthermore, the potential mechanisms that result in this toxicity, the clinical impact of thyroid dysfunction in these patients and the controversies regarding treatment with thyroid hormone (TH) therapy are evaluated.
  
  
  CONCLUSIONS
  Detection of TKI-induced thyroid dysfunction requires routine monitoring of thyroid function and may necessitate treatment. Potential benefits in developing thyroid dysfunction and potential harm in treating it necessitate controlled studies. Finally, if treatment is pursued, appropriate dosing and timing of TH replacement will require prospective clinical evaluation.
authors.affiliation: University of Pisa, Department of Clinical and Experimental Medicine , Via Savi 10, 56126, Pisa , Italy.
authors.forename: Poupak
authors.initials: P
authors.lastname: Fallahi
authors.forename: Silvia M
authors.initials: SM
authors.lastname: Ferrari
authors.forename: Roberto
authors.initials: R
authors.lastname: Vita
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Domenicantonio
authors.forename: Alda
authors.initials: A
authors.lastname: Corrado
authors.forename: Salvatore
authors.initials: S
authors.lastname: Benvenga
authors.forename: Alessandro
authors.initials: A
authors.lastname: Antonelli
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016903:Drug Monitoring / Q000379:methods; D006801:Humans; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D013959:Thyroid Diseases / Q000139:chemically induced* / Q000503:physiopathology; D013960:Thyroid Function Tests / Q000379:methods; D013963:Thyroid Hormones / Q000008:administration & dosage
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D013963:Thyroid Hormones
keywords: axitinib; dasatinib; hyperthyroidism; hypothyroidism; imatinib; motesanib; nilotinib; pazopanib; sorafenib; sunitinib; thyroid cancer; thyroid dysfunctions; tivozanib; tyrosine kinase inhibitors; vandetanib