Oncological Endocrinology Unit, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, University of Turin, Turin, Italy.
Oncological Endocrinology Unit, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, University of Turin, Turin, Italy; Endocrinology and Metabolic Diseases Unit, AO SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
Crit Rev Oncol Hematol. 2021 Dec;168:103533. doi: 10.1016/j.critrevonc.2021.103533. Epub 2021 Nov 19.
Over the past decade, the prognosis of advanced thyroid cancer (TC) patients has dramatically improved thanks to the introduction of tyrosine kinase inhibitors (TKIs). Despite their effectiveness, these drugs are burdened with several side effects that can negatively affect quality of life and compromise therapy continuation. Among renal adverse events (RAEs), proteinuria is the most frequently reported in clinical trials and real-life experiences, especially during treatment with lenvatinib or cabozantinib. This peculiar toxicity is commonly associated with targeted therapies with anti-angiogenic activity, even if the mechanisms underlying its onset and progression are not entirely clear. RAEs should be early recognized and properly managed to avoid renal function worsening and life-threatening consequences. Aiming at providing a comprehensive summary that can help clinicians to identify and manage TKIs-related RAEs in TC patients, we reviewed the current evidence about this topic, from pathogenesis and potential risk factors to diagnosis and treatment.
在过去的十年中,由于酪氨酸激酶抑制剂(TKIs)的引入,晚期甲状腺癌(TC)患者的预后得到了显著改善。尽管这些药物非常有效,但它们也存在多种副作用,会对生活质量产生负面影响,并影响治疗的持续进行。在肾不良反应(RAEs)中,蛋白尿在临床试验和真实世界的经验中最为常见,尤其是在使用仑伐替尼或卡博替尼治疗时。这种特殊的毒性通常与具有抗血管生成活性的靶向治疗相关,尽管其发生和进展的机制尚不完全清楚。RAEs 应及早识别并妥善处理,以避免肾功能恶化和危及生命的后果。为了提供全面的总结,以帮助临床医生识别和处理 TC 患者的 TKI 相关 RAEs,我们回顾了目前关于该主题的证据,包括发病机制和潜在的危险因素,以及诊断和治疗。