Acitelli E, Verrienti A, Sponziello M, Pecce V, Minicocci I, Macera M, Barp S, Lucia P, Grani G, Durante C, Maranghi M
Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
Endocrine. 2025 Feb;87(2):619-626. doi: 10.1007/s12020-024-04003-y. Epub 2024 Sep 17.
Multitarget kinase inhibitors (MKIs) are effective options in the treatment of cancer, significantly increasing the progression-free survival (PFS) of many tumors. Data about severity and prevalence of metabolic adverse events is scarce and may be significant in patients with a better survival. The aim of this study was to investigate glucose and lipids values of patients treated with lenvatinib. Secondary aims included evaluating changes in the estimated risk of cardiovascular disease and the relationship between metabolic alterations and tumor response to therapy.
A retrospective pilot study on 29 patients with advanced differentiated thyroid cancer was conducted. Clinical and biochemical characteristics were collected at the day of therapy initiation and follow up. The 10-year risk of cardiovascular disease was estimated with the SCORE2 and SCORE2-OP algorithms. Tumor burden change was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST).
No differences in glucose values were observed. A significant increase in total cholesterol (208 ± 41 versus 245 ± 67 mg/dl), triglycerides (112 [interquartile range, 58-326] versus 157 [78-296] mg/dl), calculated LDL cholesterol (128 [66-204] versus 140 [81-308] mg/dl) and cardiovascular risk was observed from baseline to follow up. Furthermore, these parameters increase progressively with increasing tumor response to therapy.
Despite limitations, this study shows an association between the use of lenvatinib and the development of lipid alterations in patients with advanced thyroid cancer. However, further investigation is necessary for a more comprehensive understanding of the adverse metabolic profile of MKIs.
多靶点激酶抑制剂（MKIs）是癌症治疗的有效选择，可显著提高许多肿瘤的无进展生存期（PFS）。关于代谢不良事件的严重程度和发生率的数据稀缺，而在生存期较长的患者中可能具有重要意义。本研究的目的是调查接受乐伐替尼治疗的患者的血糖和血脂值。次要目的包括评估心血管疾病估计风险的变化以及代谢改变与肿瘤治疗反应之间的关系。
对29例晚期分化型甲状腺癌患者进行了一项回顾性试点研究。在治疗开始日和随访时收集临床和生化特征。使用SCORE2和SCORE2-OP算法估计心血管疾病的10年风险。根据实体瘤疗效评价标准（RECIST）评估肿瘤负荷变化。
未观察到血糖值有差异。从基线到随访，总胆固醇（208±41对245±67mg/dl）、甘油三酯（112[四分位间距，58 - 326]对157[78 - 296]mg/dl）、计算得出的低密度脂蛋白胆固醇（128[66 - 204]对140[81 - 308]mg/dl）和心血管风险均显著增加。此外，这些参数随着肿瘤对治疗反应的增加而逐渐升高。
尽管存在局限性，但本研究表明乐伐替尼的使用与晚期甲状腺癌患者脂质改变的发生之间存在关联。然而，需要进一步研究以更全面地了解MKIs的不良代谢特征。
