title: [Management of side-effects of targeted therapies in renal cancer: endocrine side-effects and metabolic disorders].
abstract: Several types of endocrine complications and metabolic disorders can occur during treatment with targeted therapies: thyroid dysfunction, hyperglycaemia, hyperlipidaemia, etc. Thyroid dysfunctions are mainly observed with tyrosine kinase inhibitors (TKI), with a high frequency with sunitinib (18 to 85%) and sorafenib (21%). Hypothyroidism can be symptomatic with clinical signs including asthenia, constipation, cold intolerance, with elevated TSH and low free T 4 levels; or subclinical with non-specific clinical signs (asthenia) with TSH less than 8-10mIU/L and free T 4 normal, and often requiring supplementation with thyroid hormones. The occurrence of thyroid dysfunction does not mean that treatment with TKI must be stopped. Thyrotoxicosis, usually transient, can precede the onset of hypothyroidism during treatment with TKI. Specialist opinion from an endocrinologist should be considered with the occurrence of thyroid dysfunction. Abnormalities in the glycaemic and lipid profile are often seen with mTOR inhibitors and require monitoring before and during the treatment, as well as a specialist opinion from an endocrinologist in the event of hyperglycaemia or dyslipidaemia.
authors.affiliation: CHU Rangueil-Larrey, Service d'endocrinologie, maladies métaboliques et nutrition, Pôle cardiovasculaire et métabolique, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse Cedex 9, France. Electronic address: caron.p@chu-toulouse.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Caron
authors.affiliation: Institut Paoli-Calmettes, 232, boulevard Sainte-Marguerite, 13273 Marseille Cedex 9, France.
authors.forename: Gwenaëlle
authors.initials: G
authors.lastname: Gravis
authors.affiliation: CHU HEGP, oncologie médicale, 20, rue Leblanc, 75908 Paris Cedex 15, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Oudard
authors.affiliation: CHU Cochin, urologie, 27, rue du Faubourg-Saint-Jacques, 75679 Paris Cedex 14, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Pignot
keywords: hypercholesterolemia; hypercholestérolemie; hyperglycaemia; hyperglycémie; hypertriglyceridemia; hypertriglycéridémie; hypothyroidism; hypothyroïdie