Korean J Clin Pharm.
2024 Sep;34(3):184-193. 10.24304/kjcp.2024.34.3.184.
Predictive Factors and Prognostic Relevance of Sunitinib-induced Subclinical and Overt Hypothyroidism in Korean Patients with Metastatic Renal Cell Carcinoma
- Affiliations
-
- 1College of Pharmacy, Research Institute of Pharmaceutical Sciences & Natural Products Research Institute, Seoul National University, Seoul 08826, Republic of Korea
- 2Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Republic of Korea
- 3Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
- 4Cancer Research Institute, Seoul National University, Seoul 03080, Republic of Korea
- KMID: 2564373
- DOI: http://doi.org/10.24304/kjcp.2024.34.3.184
Abstract
- Background
Sunitinib, commonly used for metastatic renal cell carcinoma (mRCC), often induces hypothyroidism, affecting 27 to 85% of patients. There are clues suggesting an association between sunitinib-induced hypothyroidism and improved survival outcomes. This study aims to identify the predictive factors of sunitinib-induced hypothyroidism and evaluate whether the occurrence of overt or subclinical hypothyroidism predicts tumor outcome in patients with mRCC.
Methods
Patients administered to sunitinib for mRCC was included in this retrospective study. Log-rank test and Cox proportional hazards model were conducted to identify predictive factors of hypothyroidism and prognostic factors of progression-free survival (PFS) and overall survival (OS).
Results
A total of 156 patients with mRCC treated with sunitinib were included. Predictive factors of sunitinib-induced hypothyroidism were female (odds ratio (OR), 2.77), sunitinib-induced hypertension (OR, 2.99) and dose reduction of sunitinib due to intolerance (OR, 3.57). Sunitinib-induced overt hypothyroidism was a significant prognostic factor in predicting PFS and OS (hazard ratio, 0.38 and 0.23, respectively). Thyroid hormone replacement did not have an influence on PFS and OS.
Conclusions
Female patients, patients who experienced sunitinib-induced hypertension and sunitinib dose reduction are at higher risk of hypothyroidism and need close monitoring. Overt hypothyroidism is a strong prognostic factor of sunitinib treatment outcome in mRCC patients and thyroid hor- mone replacement does not have a negative effect on tumor outcome.
