Sunitinib-induced hypothyroidism predicts progression-free survival in metastatic renal cell carcinoma patients.
Sunitinib is a tyrosine kinase inhibitor (TKI) used in treatment of metastatic renal cell carcinoma (mRCC), gastrointestinal stromal tumors and pancreatic neuroendocrine tumors. One of the most common side effects related to sunitinib is hypothyroidism. Recent trials suggest correlation between the incidence of hypothyroidism and treatment outcome in patients treated with TKI. This study evaluates whether development of hypothyroidism is a predictive marker of progression-free survival (PFS) in patients with mRCC treated with sunitinib. Twenty-seven patients diagnosed with clear cell mRCC, after nephrectomy and in 'good' or 'intermediate' MSKCC risk prognostic group, were included in the study. All patients received sunitinib as a first-line treatment on a standard schedule (initial dose 50 mg/day, 4 weeks on, 2 weeks off). The thyroid-stimulating hormone serum levels were obtained at the baseline and every 12 weeks of treatment. In statistic analyses, we used Kaplan-Meier method for assessment of progression-free survival; for comparison of survival, we used log-rank test. In our study, the incidence of hypothyroidism was 44%. The patients who had developed hypothyroidism had better median PFS to patients with normal thyroid function 28,3 months [95% (CI) 20.4-36.2 months] versus 9.8 months (6.4-13.1 months). In survival analysis, we perceive that thyroid dysfunction is a predictive factor of a progression-free survival (PFS). In the unified group of patients, the development of hypothyroidism during treatment with sunitinib is a positive marker for PFS. During that treatment, thyroid function should be evaluated regularly.
Department of Oncology, University Hospital in Krakow, Sniadeckich 10, 31-531, Cracow, Poland.
Anna
A
Buda-Nowak
Department of Experimental and Clinical Surgery, Jagiellonian University Medical College, Michalowskiego 12, Cracow, 31-126, Poland. jakub.kucharz@uj.edu.pl.|Department of Uro-Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Roentgena 5, 02-781, Warsaw, Poland. jakub.kucharz@uj.edu.pl.
Jakub
J
Kucharz
Department of Medical Diagnostics, Jagiellonian University Medical College, Medyczna 9, 30-688, Cracow, Poland.
Paulina
P
Dumnicka
Department of Nephrology, Jagiellonian University Medical College, Kopernika 15, 31-501, Cracow, Poland.
Marek
M
Kuzniewski
Department of Experimental and Clinical Surgery, Jagiellonian University Medical College, Michalowskiego 12, Cracow, 31-126, Poland.
Roman Maria
RM
Herman
Department of Oncology, University Hospital in Krakow, Sniadeckich 10, 31-531, Cracow, Poland.
Aneta L
AL
Zygulska
Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, Kopernika 15A, 31-501, Cracow, Poland.
Beata
B
Kusnierz-Cabala
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000188:drug therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced*; D007211:Indoles / Q000009:adverse effects* / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D011758:Pyrroles / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D000077210:Sunitinib
D007211:Indoles; D047428:Protein Kinase Inhibitors; D011758:Pyrroles; D000077210:Sunitinib
Hypothyroidism; Predictive factor; Prognosis; Progression-free survival; Renal cell carcinoma; Sunitinib