Prevalence and Associated Factors for Thyroid Dysfunction Among Patients On Targeted Therapy for Cancers: A Single-Center Study from Thailand

Korawan Chawalitmongkol; Kunlatida  Maneenil; Pravinwan  Thungthong; Chaicharn  Deerochanawong

doi:10.15605/jafes.038.02.18

Authors

Korawan Chawalitmongkol Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand https://orcid.org/0000-0001-8116-758X
Kunlatida Maneenil Rajavithi Hospital, College of Medicine, Rangsit University,Bangkok, Thailand https://orcid.org/0009-0004-0194-4860
Pravinwan Thungthong Rajavithi hospital, College of Medicine, Rangsit University,Bangkok, Thailand https://orcid.org/0000-0001-8287-2096
Chaicharn Deerochanawong Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand https://orcid.org/0000-0001-9666-7050

DOI:

https://doi.org/10.15605/jafes.038.02.18

Keywords:

thyroid dysfunction, tyrosine kinase inhibitor, immune checkpoint inhibitor, immunotherapy, malignancy

Abstract

Objective. This study aimed to explore the prevalence and associated factors of thyroid dysfunction among cancer patients treated with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs).

Methodology. A cross-sectional study was done in patients who received TKIs at Rajavithi Hospital in 2019. For patients treated with ICI, a retrospective chart review for patients seen in 2018 to 2019 was conducted. If there were abnormal thyroid function tests (TFT), thyroid autoantibodies were tested.

Results. There were 144 patients on TKIs with a mean age of 56.0 years. Thyroid dysfunction was found in 14.6% of patients and most had subclinical hypothyroidism (n=16, 11.1%). Imatinib (n=11, 10.8%) and sunitinib (n=4, 100%) were the 2 most common TKIs given to patients with thyroid dysfunction. Thyroid dysfunction was associated with male sex, chronic kidney disease and hepatitis B virus infection but not with previous thyroid disease and presence of thyroid autoantibodies.

There were 18 patients who received ICIs. The mean age was 63.3 years. Twelve patients (66.7%) used programmed cell
death protein-1 antibody (anti-PD1), mainly nivolumab. Thyroid dysfunction was found in 50%, which occurred at a median duration of 46 days. Most patients had overt hypothyroidism and 55.6% needed levothyroxine replacement.

Conclusion. Thyroid dysfunctions from TKIs were mostly asymptomatic and mild in severity. Some types of TKIs might be associated with thyroid dysfunction. On the other hand, thyroid dysfunction from ICIs usually occurs within 6 months and requires levothyroxine replacement.

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Author Biographies

Korawan Chawalitmongkol, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

Division of Endocrinology and Metabolism, Department of Medicine

Kunlatida Maneenil, Rajavithi Hospital, College of Medicine, Rangsit University,Bangkok, Thailand

Division of Oncology, Department of Medicine

Pravinwan Thungthong, Rajavithi hospital, College of Medicine, Rangsit University,Bangkok, Thailand

Division of Hematology

Chaicharn Deerochanawong, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

Division of Endocrinology and Metabolism, Department of Medicine

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