Department of Endocrinology and Metabolism, CHU Lille, 59037 Lille, France.
Medical Oncology Department, Oscar Lambret Cancer Centre, Lille, France; Medical Oncology Department, CHU Lille, 59037, Lille France.
Crit Rev Oncol Hematol. 2019 Sep;141:23-35. doi: 10.1016/j.critrevonc.2019.05.015. Epub 2019 May 31.
Recently, tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICPIs) have emerged as new classes of anticancer therapies. Although generally considered less toxic than cytotoxic chemotherapy, these new drugs can cause significant unanticipated side effects including thyroid dysfunction. This review provides a literature assessment of thyroid dysfunctions induced by TKI and ICPIs. We intend to define for these two classes the frequency of thyroid involvement, the potential mechanisms that result in this toxicity, the clinical-biological impact and the therapeutic management. Detection of thyroid dysfunction requires monitoring of TSH, in combination with free T4 if needed and, depending on the clinical impact and the kinetics of biological abnormalities, starting symptomatic treatment of hyperthyroidism and/or correcting hypothyroidism.
最近,酪氨酸激酶抑制剂(TKI)和免疫检查点抑制剂(ICPIs)已成为新型抗癌疗法。尽管它们通常被认为比细胞毒性化疗药物毒性更小,但这些新药可引起显著的意外副作用,包括甲状腺功能障碍。本综述提供了 TKI 和 ICPIs 引起的甲状腺功能障碍的文献评估。我们旨在为这两类药物确定甲状腺受累的频率、导致这种毒性的潜在机制、临床生物学影响和治疗管理。检测甲状腺功能障碍需要监测 TSH,如果需要,结合游离 T4,并根据临床影响和生物学异常的动力学,开始对甲亢进行对症治疗和/或纠正甲减。