Oncological Department, University Hospital, Krakow, Poland.
Endokrynol Pol. 2012;63(4):302-6.
Tyrosine kinase inhibitors are relatively new targeted therapy drugs used for the treatment of metastatic clear cell kidney carcinoma, gastrointestinal stromal tumours, thyroid carcinoma and pancreatic neuroendocrine tumours during the progression of the disease. Hypothyroidism or thyroid dysfunction is often a side effect of this treatment. Therefore, monitoring of thyroid hormone levels before the beginning and during the treatment of tyrosine kinase inhibitors is a necessity. Hypothyroidism correlates with objective response to the treatment. Sunitinib. This is the most described tyrosine kinase inhibitor which causes hypothyroidism. The mechanism of hypothyroidism is still unclear. Sorafenib. Symptoms of hypothyroidism occur in 18% of patients treated with sorafenib due to metastatic renal cell carcinoma. Imatinib. Hypothyroidism is one of the most frequent side effects of the treatment. Emergent tracheotomy was necessary due to larynx swelling during marked hypothyroidism. Motesanib. Hypothyroidism or increased TSH level is diagnosed in 22% to 69% of patients with metastatic differentiated or medullary thyroid carcinomas. The management of patients with thyroid dysfunction and related symptoms such as fatigue is undoubtedly a challenge to an oncologist.
酪氨酸激酶抑制剂是一种相对较新的靶向治疗药物，用于治疗转移性透明细胞肾细胞癌、胃肠道间质瘤、甲状腺癌和胰腺神经内分泌肿瘤，在疾病进展过程中使用。甲状腺功能减退症或甲状腺功能障碍是这种治疗的常见副作用。因此，在开始使用酪氨酸激酶抑制剂治疗之前和治疗期间监测甲状腺激素水平是必要的。甲状腺功能减退症与对治疗的客观反应相关。舒尼替尼。这是描述最多的引起甲状腺功能减退症的酪氨酸激酶抑制剂。甲状腺功能减退症的发生机制尚不清楚。索拉非尼。由于转移性肾细胞癌，18%接受索拉非尼治疗的患者出现甲状腺功能减退症症状。伊马替尼。甲状腺功能减退症是治疗中最常见的副作用之一。由于明显甲状腺功能减退症导致喉肿胀，需要紧急气管切开术。莫特沙尼。在转移性分化型或髓样甲状腺癌患者中，22%至 69%的患者被诊断为甲状腺功能减退症或 TSH 水平升高。对有甲状腺功能障碍和相关症状（如疲劳）的患者进行管理，对肿瘤学家来说无疑是一个挑战。
