Association between newonset hypothyroidism and c

Authors: Mehmet Asim Bilen Amy Patel Kenneth R Hess Javier Munoz Naifa L Busaidy Jennifer J Wheler Filip Janku Gerald S Falchook David S Hong Funda MericBernstam Mouhammed Amir Habra Aung Naing

Publish Date: 2016/06/10

Volume: 78, Issue: 1, Pages: 167-171

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Abstract

Tyrosine kinase inhibitor TKIinduced thyroid dysfunction has been identified as an important but manageable adverse effect of targeted therapy Several studies have suggested that patients who develop hypothyroidism respond better to TKIs but this relationship is not well elucidated We evaluated the relationship between newonset hypothyroidism and clinical response in patients with advanced cancers treated with TKIs at our institutionWe retrospectively reviewed records for patients from four clinical trials that included at least one TKI  therapy between January 2006 and December 2011 Patients with preexisting thyroid disease including thyroid cancer hypothyroidism or hyperthyroidism were excluded Analysis of 197 patients was performed Response was determined using RECIST 10 Clinical benefit was described as complete response partial response or stable disease greater than 4 months Multivariable logistic regression analysis was performed to correlate patient characteristics with clinical responseThe median age for the 197 patients was 58 years range 13–85 years and 56  were female Of the 197 patients 52 26  developed hypothyroidism after therapy Clinical benefit rates were 50  in patients with newonset hypothyroidism versus 34  in patients without hypothyroidism In the univariate model the odds ratio OR for newonset hypothyroidism was 19 95  confidence interval CI 10 36 and p = 005 We grouped tumor types into six categories breast colorectal carcinoma melanoma nonsmall cell lung cancer pancreas and other When adjusted for tumor type age 50 years and sex the OR was 29 95  CI 13 65 and p = 0012 for newonset hypothyroidismThis study was supported by the NIH/NCI under Award Number P30CA016672 and used the Clinical Trials Support Resource The results of this study were presented in a poster at the American Association for Cancer Research annual meeting in San Diego CA on April 7 2014

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