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Annals of Oncology Advance Access originally published online on October 24, 2007
Annals of Oncology 2008 19(2):265-268; doi:10.1093/annonc/mdm483
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© 2007 European Society for Medical Oncology. For Permissions, please email: journals.permissions@oxfordjournals.org

urogenital tumors

Thyroid function test abnormalities in patients with metastatic renal cell carcinoma treated with sorafenib

I. Tamaskar1,*, R. Bukowski1, P. Elson1, A. G. Ioachimescu2, L. Wood1, R. Dreicer1, T. Mekhail1, J. Garcia1 and B. I. Rini1

1 Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Center
2 Departments of Endocrinology, Diabetes and Metabolism, Cleveland Clinic Foundation, Cleveland, USA

* Correspondence to: Dr I. Tamaskar, Experimental Therapeutic Program, Cleveland Clinic Taussig Cancer Center, 9500 Euclid Avenue/R35, Cleveland, OH 44195, USA. Tel: +1-216-444-6825; Fax: +1-216-444-0114; E-mail: tamaski{at}ccf.org

Background: Sorafenib is an orally bioavailable vascular endothelial growth factor receptor (VEGFR) inhibitor with antitumor activity in metastatic renal cell carcinoma (RCC). Sunitinib, also a VEGFR inhibitor, induces biochemical hypothyroidism in 85% of metastatic RCC patients, the majority of whom have signs or symptoms of hypothyroidism. Hence, the incidence of thyroid function test (TFT) abnormalities in patients with metastatic RCC receiving sorafenib was investigated.

Patients and methods: Sixty-eight patients with metastatic RCC were treated with sorafenib at the Cleveland Clinic Taussig Cancer Center, and 39 patients had TFTs available.

Results: Eight patients (21%) had thyroid dysfunction possibly caused by sorafenib [seven hypothyroidism (18%) and one hyperthyroidism (3%)] and eight additional patients (21%) had findings compatible with nonthyroidal illness. Only two patients had clinical signs and symptoms secondary to thyroid dysfunction and received thyroid hormone replacement.

Conclusions: In summary, clinically significant TFT abnormalities were not common in patients treated with sorafenib, and replacement therapy was rarely indicated. TFTs should be measured before sorafenib therapy in RCC patients and subsequently only if clinically indicated.

Key words: metastatic renal cell carcinoma, sorafenib, thyroid function abnormalities

Received for publication May 16, 2007. Revision received September 7, 2007. Accepted for publication September 13, 2007.


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