title: Is sunitinib-induced hypothyroidism a predictive clinical marker for better response in metastatic renal cell carcinoma patients?
abstract: BACKGROUND
  The main goal of this study was to examine whether the occurrence of hypothyroidism during sunitinib therapy in patients with metastatic renal cell carcinoma (mRCC) is associated with a better outcome.
  
  
  METHODS
  The study enrolled 81 patients with pathologically proven mRCC who were treated with sunitinib between March 2008 and June 2013.Thyroid function evaluation comprised (free-thyroxine) FT4 and thyroid-stimulating hormone (TSH) before treatment and at day 1 of each 6-week cycle. Survival analysis was performed using the Kaplan-Meier method, and the differences among the groups were determined using the log-rank test.
  
  
  RESULTS
  Hypothyroidism occurred in 30 (37%) of 81 patients within a median 3 months (range 1-18) of treatment initiation. There was a statistically significant correlation between the occurrence of hypothyroidism during treatment and the rate of objective remission (ORR) (hypothyroid patients vs euthyroid patients: 46.7 vs 13.7%, respectively; P = 0.001). Median progression-free survival (PFS) was 10 (95% CI 6.13-13.8) months in the euthyroid patients, and 17 (95% CI 9.33-24.6) months in the hypothyroid patients (P = 0.001). The median overall survival (OS) was 39 (95% CI 25.4-52.5) months in the hypothyroid patients and 20 (95% CI 14.7-25.2) months in the euthyroid patients (P = 0.019).
  
  
  CONCLUSIONS
  The occurrence of hypothyroidism during treatment in patients was significantly associated with longer PFS, OS and better ORR in the current study.
authors.affiliation: a Department of Medical Oncology , Erciyes University Faculty of Medicine , Kayseri , Turkey.
authors.forename: Oktay
authors.initials: O
authors.lastname: Bozkurt
authors.affiliation: a Department of Medical Oncology , Erciyes University Faculty of Medicine , Kayseri , Turkey.
authors.forename: Halit
authors.initials: H
authors.lastname: Karaca
authors.affiliation: b Department of Medical Oncology , Trakya University Faculty of Medicine , Edirne , Turkey.
authors.forename: Ilhan
authors.initials: I
authors.lastname: Hacıbekiroglu
authors.affiliation: c Department of Medical Oncology , Dicle University Faculty of Medicine , Diyarbakır , Turkey.
authors.forename: Muhammed Ali
authors.initials: MA
authors.lastname: Kaplan
authors.affiliation: d Department of Internal Medicine , Dicle University Faculty of Medicine , Diyarbakır , Turkey.
authors.forename: Yakup
authors.initials: Y
authors.lastname: Duzkopru
authors.affiliation: e Department of Medical Oncology , Afyon Kocatepe University Faculty of Medicine , Turkey.
authors.forename: Mukremin
authors.initials: M
authors.lastname: Uysal
authors.affiliation: f Kayseri Training and Research Hospital , Medical Oncology Department , Turkey.
authors.forename: Veli
authors.initials: V
authors.lastname: Berk
authors.affiliation: f Kayseri Training and Research Hospital , Medical Oncology Department , Turkey.
authors.forename: Mevlude
authors.initials: M
authors.lastname: Inanc
authors.affiliation: a Department of Medical Oncology , Erciyes University Faculty of Medicine , Kayseri , Turkey.
authors.forename: Ayse Ocak
authors.initials: AO
authors.lastname: Duran
authors.affiliation: a Department of Medical Oncology , Erciyes University Faculty of Medicine , Kayseri , Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Ozaslan
authors.affiliation: a Department of Medical Oncology , Erciyes University Faculty of Medicine , Kayseri , Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Ucar
authors.affiliation: a Department of Medical Oncology , Erciyes University Faculty of Medicine , Kayseri , Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Ozkan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced* / Q000453:epidemiology*; D007211:Indoles / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011758:Pyrroles / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077210:Sunitinib; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib
keywords: Hypothyroidism; Metastatic renal cell cancer; Prognosis; Sunitinib