Current evidence on thyroid related adverse events in patients treated with protein tyrosine kinase inhibitors.

Current evidence on thyroid related adverse events in patients treated with protein tyrosine kinase inhibitors. Drug Metab Rev. 2019 Nov 13;:1-8 Authors: Gabora K, Piciu A, Bădulescu IC, Larg MI, Stoian IA, Piciu D Abstract Tyrosine kinase inhibitors (TKI) are gaining more ground in oncology, they are widely used in the treatment of multiple types of cancers; still important side effects limit their efficacy. The aim of this study is to evaluate the existing medical literature on TKI induced thyroid dysfunction, to assess the adverse effects of targeted therapy on thyroid function in oncological patients and to evaluate the effects of thyroid dysfunction on disease prognosis. We included in this review 22 original studies published between 2010 and 2019. We used the PubMed database to search for articles upon the development of hypothyroidism and hyperthyroidism in TKI treated patients. After a careful review of the existing literature, we selected the relevant studies and cross-referenced the bibliography of each paper. A number of 1641 patients were included in our review. We found that thyroid dysfunction is not a rare side effect of TKI treatment, approximately 33% of the total number of patients presented clinical hypothyroidism. We also studied the necessity of thyroid hormone substitution treatment, a quarter of evaluated patients needed substitution therapy. Multiple studies showed that there is a link between a patient developing hypothyroidism ...
Source: Drug Metabolism Reviews - Category: Drugs & Pharmacology Tags: Drug Metab Rev Source Type: research

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Authors: Halczuk KM, Boguszewska K, Urbaniak SK, Szewczuk M, Karwowski BT Abstract The thyroid is not necessary to sustain life. However, thyroid hormones (TH) strongly affect the human body. Functioning of the thyroid gland affects the reproductive capabilities of women and men, as well as fertilization and maintaining a pregnancy. For the synthesis of TH, hydrogen peroxide (H2O2) is necessary. From the chemical point of view, TH is a reactive oxygen species (ROS) and serves as an oxidative stress (OS) promoter. H2O2 concentration in the thyroid gland is much higher than in other tissues. Therefore, the thyroid is...
Source: The Yale Journal of Biology and Medicine - Category: Universities & Medical Training Tags: Yale J Biol Med Source Type: research
Ivo Iavicoli Thyroid diseases are characterized by a wide range of physical and mental symptoms that can affect biological function, emotional and social life of patients. However, their impact on work functioning is not yet fully understood. Therefore, this review aims to address the way in which thyroid diseases can affect occupational outcomes, i.e., the employment rate, sick leave, working capacity and work income of patients. A systematic review of Pubmed, Scopus and ISI Web of Knowledge databases has been performed. Although it is not possible to extrapolate precise data for benign pathologies, about a third of ...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Review Source Type: research
ConclusionMany experimental studies suggest a link between hyperthyroidism/hypothyroidism and BC. We were able to demonstrate an epidemiological association between thyroiditis and an increased BC risk. This shows the need for close monitoring for BC in women with thyroiditis.
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
SummaryCytotoxic T lymphocyte-associated antigen-4 (CTLA-4), the first immune checkpoint to be targeted clinically, has provided an effective treatment option for various malignancies. However, the clinical advantages associated with CTLA-4 inhibitors can be offset by the potentially severe immune-related adverse events (IRAEs), including autoimmune thyroid dysfunction. To investigate the candidate genes and signaling pathways involving in autoimmune thyroid dysfunction related to anti-CTLA-4 therapy, integrated differentially expressed genes (DEGs) were extracted from the intersection of genes from Gene Expression Omnibus...
Source: Investigational New Drugs - Category: Drugs & Pharmacology Source Type: research
ConclusionsBTMs help us to better understand mechanisms of the impact of hormonal disorders and their treatment on bone metabolism. However, it is unknown whether BTMs may be used to monitor the effect of their treatments on bone in the clinical practice.
Source: Journal of Endocrinological Investigation - Category: Endocrinology Source Type: research
CONCLUSIONS: Immune checkpoint inhibitor-associated thyroiditis is a distinct clinical entity. Mechanisms underlying aetiology remain largely unknown. Awareness amongst health professionals is important to limit morbidity and avoid unnecessary periods of untreated hypothyroidism. PMID: 32264785 [PubMed - as supplied by publisher]
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
Conclusion: Malignancy-associated hyperthyroidism has a similar underlying mechanism to subacute thyroiditis, in so much as there is damage or destruction of thyroid tissue. In cases of subacute thyroiditis this damage is self-limited, and there is recovery of thyroid function. In some cases of thyroiditis associated with malignancy there may be thyroid gland recovery as the underlying malignancy is treated and controlled. However, if the malignancy progresses, eventual hypothyroidism is likely to ensue. PMID: 32154117 [PubMed]
Source: Clinical Lung Cancer - Category: Cancer & Oncology Authors: Tags: J Clin Transl Endocrinol Source Type: research
ConclusionsEarly radioiodine treatment will potentially reduce mortality and should be offered to patients with severe disease. However, thionamides are still suitable for patients with milder disease, contraindications to radioiodine, or individuals who choose to avoid permanent hypothyroidism. Ultimately, a patient individualised approach that prioritises early and  sustained control of hyperthyroidism will improve long-term outcomes regardless of the therapy modality used.
Source: Thyroid Research - Category: Endocrinology Source Type: research
ConclusionMalignancy-associated hyperthyroidism has a similar underlying mechanism to subacute thyroiditis, in so much as there is damage or destruction of thyroid tissue. In cases of subacute thyroiditis this damage is self-limited, and there is recovery of thyroid function. In some cases of thyroiditis associated with malignancy there may be thyroid gland recovery as the underlying malignancy is treated and controlled. However, if the malignancy progresses, eventual hypothyroidism is likely to ensue.
Source: Journal of Clinical and Translational Endocrinology - Category: Endocrinology Source Type: research
Imaging tests of the neck assist in the diagnosis and management of thyroid conditions including thyroid cancer. Ultrasound (US) is usually the first imaging test used. For nodules in the neck, US is usually appropriate to determine cancer risk. CT with or  without intravenous (IV) contrast may also be appropriate. For suspected enlarged thyroid (goiter), US or CT without IV contrast is usually appropriate. CT with IV contrast, MRI, or nuclear medicine scan may also be appropriate. If overactive thyroid (hyperthyroidism) or excessive thyr oid hormone (thyroto...
Source: Journal of the American College of Radiology : JACR - Category: Radiology Authors: Tags: Appropriate use criteria Source Type: research
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