Ιmpact of sunitinib-induced hypothyroidism on survival of patients with metastatic renal cancer
Abstract Background Sunitinib plays an important role in managing the metastatic renal cell cancer (mRCC). Sunitinib-induced hypothyroidism is a common side-effect of the drug. There have been attempts to link hypothyroidism with a better clinical outcome in sunitinib-treated (mRCC) patients. Our ai...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-019-5610-8 |
| _version_ | 1818160241066377216 |
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| author | Theofanis Vasileiadis Michail Chrisofos Michail Safioleas Konstantinos Kontzoglou Konstantinos Papazisis Athina Sdrolia |
| author_facet | Theofanis Vasileiadis Michail Chrisofos Michail Safioleas Konstantinos Kontzoglou Konstantinos Papazisis Athina Sdrolia |
| author_sort | Theofanis Vasileiadis |
| collection | DOAJ |
| description | Abstract Background Sunitinib plays an important role in managing the metastatic renal cell cancer (mRCC). Sunitinib-induced hypothyroidism is a common side-effect of the drug. There have been attempts to link hypothyroidism with a better clinical outcome in sunitinib-treated (mRCC) patients. Our aim was to relate the impact of hypothyroidism to the survival of these patients. Methods We have evaluated 70 patients with mRCC that received sunitinib as a first line treatment. Thyroid-stimulating hormone (TSH) was measured at baseline, after 15 days of treatment (day-15) and at the end of the second cycle (day-75). Biomarker data and correlations with response were analysed with Microsoft Excel. Comparison results from Student’s t-test with a p less than 0.05 were considered statistically significant. Kaplan-Meyer and log-rank tests were performed using GraphPad Prism 5 for Windows. Results Regarding the response to treatment, a progression-free survival (PFS) of 9.47 months and an overall survival (OS) of 22.03 months were demonstrated. Our data are consistent with published data by other authors. On day-15 from the beginning of the treatment an important number of patients exhibited a TSH elevation. On day-15 42.86% had a TSH over the upper normal limit and 50.0% at the end of the second cycle (day-75). TSH increased earlier in patients that exhibited an objective response (× 3.33 times the baseline values on day-15) than patients that exhibited disease stabilisation (× 2.18) or disease progression (× 1.59). Early increases in TSH were associated with a longer PFS (11.92 vs. 8.82 months, p = 0.0476) and a longer OS (3.10 vs. 1.08 years, p = 0.0011). Conclusions Early TSH-increase is associated with a clinical benefit. The patients that showed at least a twofold increase of their baseline TSH, responded to therapy by stabilisation or by regression of disease. This is the only study to our knowledge which shows that early increases - 2 weeks from starting the treatment - in TSH levels have a prognostic value. Both PFS and OS of the patients who demonstrated a higher than a twofold rise were significantly longer than the PFS and the OS of the patients that presented a lower or no TSH-increase. |
| first_indexed | 2024-12-11T15:58:44Z |
| format | Article |
| id | doaj.art-59b87a95d19248ada281f840986e2f60 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-11T15:58:44Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-59b87a95d19248ada281f840986e2f602022-12-22T00:59:22ZengBMCBMC Cancer1471-24072019-04-011911710.1186/s12885-019-5610-8Ιmpact of sunitinib-induced hypothyroidism on survival of patients with metastatic renal cancerTheofanis Vasileiadis0Michail Chrisofos1Michail Safioleas2Konstantinos Kontzoglou3Konstantinos Papazisis4Athina Sdrolia5Theagenion Cancer HospitalUrology Department, Αttikon Hospital2nd Department of Propedeutic Surgery, Laiko HospitalSchool of Medicine, National Kapodistrian University of AthensTheagenion Cancer HospitalTheagenion Cancer HospitalAbstract Background Sunitinib plays an important role in managing the metastatic renal cell cancer (mRCC). Sunitinib-induced hypothyroidism is a common side-effect of the drug. There have been attempts to link hypothyroidism with a better clinical outcome in sunitinib-treated (mRCC) patients. Our aim was to relate the impact of hypothyroidism to the survival of these patients. Methods We have evaluated 70 patients with mRCC that received sunitinib as a first line treatment. Thyroid-stimulating hormone (TSH) was measured at baseline, after 15 days of treatment (day-15) and at the end of the second cycle (day-75). Biomarker data and correlations with response were analysed with Microsoft Excel. Comparison results from Student’s t-test with a p less than 0.05 were considered statistically significant. Kaplan-Meyer and log-rank tests were performed using GraphPad Prism 5 for Windows. Results Regarding the response to treatment, a progression-free survival (PFS) of 9.47 months and an overall survival (OS) of 22.03 months were demonstrated. Our data are consistent with published data by other authors. On day-15 from the beginning of the treatment an important number of patients exhibited a TSH elevation. On day-15 42.86% had a TSH over the upper normal limit and 50.0% at the end of the second cycle (day-75). TSH increased earlier in patients that exhibited an objective response (× 3.33 times the baseline values on day-15) than patients that exhibited disease stabilisation (× 2.18) or disease progression (× 1.59). Early increases in TSH were associated with a longer PFS (11.92 vs. 8.82 months, p = 0.0476) and a longer OS (3.10 vs. 1.08 years, p = 0.0011). Conclusions Early TSH-increase is associated with a clinical benefit. The patients that showed at least a twofold increase of their baseline TSH, responded to therapy by stabilisation or by regression of disease. This is the only study to our knowledge which shows that early increases - 2 weeks from starting the treatment - in TSH levels have a prognostic value. Both PFS and OS of the patients who demonstrated a higher than a twofold rise were significantly longer than the PFS and the OS of the patients that presented a lower or no TSH-increase.http://link.springer.com/article/10.1186/s12885-019-5610-8SunitinibHypothyroidismMetastatic renal cell cancerClear cell carcinomaThyroid-stimulating hormoneTSH |
| spellingShingle | Theofanis Vasileiadis Michail Chrisofos Michail Safioleas Konstantinos Kontzoglou Konstantinos Papazisis Athina Sdrolia Ιmpact of sunitinib-induced hypothyroidism on survival of patients with metastatic renal cancer BMC Cancer Sunitinib Hypothyroidism Metastatic renal cell cancer Clear cell carcinoma Thyroid-stimulating hormone TSH |
| title | Ιmpact of sunitinib-induced hypothyroidism on survival of patients with metastatic renal cancer |
| title_full | Ιmpact of sunitinib-induced hypothyroidism on survival of patients with metastatic renal cancer |
| title_fullStr | Ιmpact of sunitinib-induced hypothyroidism on survival of patients with metastatic renal cancer |
| title_full_unstemmed | Ιmpact of sunitinib-induced hypothyroidism on survival of patients with metastatic renal cancer |
| title_short | Ιmpact of sunitinib-induced hypothyroidism on survival of patients with metastatic renal cancer |
| title_sort | ιmpact of sunitinib induced hypothyroidism on survival of patients with metastatic renal cancer |
| topic | Sunitinib Hypothyroidism Metastatic renal cell cancer Clear cell carcinoma Thyroid-stimulating hormone TSH |
| url | http://link.springer.com/article/10.1186/s12885-019-5610-8 |
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