title: A study on the association between hyperlipidemia and hypothyroidism and the response to TKIs in metastatic renal cell carcinoma.
abstract: OBJECTIVE
  Vascular endothelial growth facto receptor-tyrosine kinase inhibitors (VEGFR-TKIs) are widely used for metastatic renal cell carcinoma (mRCC). The aim of this study was to investigate the association between the response to VEGFR-TKIs and hyperlipidemia and hypothyroidism.
  
  
  METHODS
  Clinical data on 155 patients with mRCC treated with VEGFR-TKIs at the Cancer Hospital of Chinese Academy of Medical Sciences from 2006 to 2014 were retrospectively analyzed. All patients received first-line TKI therapy. Survival analysis was performed with a significance level of 0.05 using a Kaplan-Meier curve. The χ(2) test was used for the intergroup comparison. The Cox regression model was used for the analysis of multiple factors affecting survival.
  
  
  RESULTS
  The median survival for the whole group (n = 155) was 36.2 months. A total of 57 patients (36.8 percent) developed hypothyroidism and 85 patients (54.9 percent) experienced hyperlipidemia. The response rate (RR) and median progression-free survival (mPFS) for patients with normal thyroid function were 32.7 percent and 9.1 months, respectively, 54.5 percent and 13.7 months with grade I hypothyroidism, 70.8 percent and 23.8 months with grade II hypothyroidism (P values of 0.001 and 0.017, respectively). The RR and mPFS for patients with normal blood lipids were 23.9 percent and 8.0 months, respectively, 54.0 percent and 12.9 months with grade I hyperlipidemia, 60.7 percent and 14.0 months with grade II hyperlipidemia, and 100.0 percent and 22.2 months with grade III hyperlipidemia. Significant differences in the RR and mPFS were seen between groups (the P values were 0.000 and 0.005, respectively).
  
  
  CONCLUSIONS
  Hypothyroidism or hyperlipidemia may be effective predictive factors for response to treatment with VEGFR-TKIs in mRCC patients. Large-sample studies are warranted to further prove these results.
authors.affiliation: Department of Medical Oncology, Cancer Hospital (Institute), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Medical Oncology, Cancer Hospital (Institute), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Chunxia
authors.initials: C
authors.lastname: Du
authors.affiliation: Department of Medical Oncology, Cancer Hospital (Institute), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Cancer Hospital (Institute), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yongkun
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Medical Oncology, Cancer Hospital (Institute), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Medical Oncology, Cancer Hospital (Institute), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Chengxu
authors.initials: C
authors.lastname: Cui
authors.affiliation: Department of Medical Oncology, Cancer Hospital (Institute), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yihebali
authors.initials: Y
authors.lastname: Chi
authors.affiliation: Department of Urology Surgery, Cancer Hospital (Institute), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Shou
authors.affiliation: Department of Medical Oncology, Cancer Hospital (Institute), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Aiping
authors.initials: A
authors.lastname: Zhou
authors.affiliation: Department of Medical Oncology, Cancer Hospital (Institute), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jinwan
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, Cancer Hospital (Institute), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000097:blood / Q000188:drug therapy* / Q000201:enzymology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000201:enzymology*; D007037:Hypothyroidism / Q000201:enzymology*; D007680:Kidney Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D016019:Survival Analysis; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000037:antagonists & inhibitors*; D055815:Young Adult
chemical_list: D047428:Protein Kinase Inhibitors; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: hyperlipidemia; hypothyroidism; renal cell carcinoma; tyrosine kinase inhibitor