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Anticancer Drug-induced Thyroid Dysfunction.
Eur Endocrinol. 2020 Apr; 16(1):32-39.EE

Abstract

Cancer immunotherapy and targeted therapy, though less toxic than conventional chemotherapy, can increase the risk of thyroid dysfunction. Immune checkpoint inhibitors render the cancer cells susceptible to immune destruction, but also predispose to autoimmune disorders like primary hypothyroidism as well as central hypothyroidism secondary to hypophysitis. Tyrosine kinase inhibitors act by blocking vascular endothelial growth factor receptors and their downstream targets. Disruption of the vascular supply from the inhibition of endothelial proliferation damages not only cancer cells but also organs with high vascularity like the thyroid. Interferon-α, interleukin-2 and thalidomide analogues can cause thyroid dysfunction by immune modulation. Alemtuzumab, a monoclonal antibody directed against the cell surface glycoprotein CD52 causes Graves' disease during immune reconstitution. Metaiodobenzylguanidine, combined with 131-iodine, administered as a radiotherapeutic agent for tumours derived from neural crest cells, can cause primary hypothyroidism. Bexarotene can produce transient central hypothyroidism by altering the feedback effect of thyroid hormone on the pituitary gland. Thyroid dysfunction can be managed in the usual manner without a requirement for dose reduction or discontinuation of the implicated agent. This review aims to highlight the effect of various anticancer agents on thyroid function. Early recognition and appropriate management of thyroid disorders during cancer therapy will help to improve treatment outcomes.

Authors+Show Affiliations

Max Super Speciality Hospital, Patparganj, New Delhi, India.All Indian Institute of Medical Sciences, New Delhi, India.Medanta, The Medicity, Gurugram, India.Narayana Superspeciality Hospital, Gurugram, India.Bharti Hospital, Karnal, India.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32595767

Citation

Bhattacharya, Saptarshi, et al. "Anticancer Drug-induced Thyroid Dysfunction." European Endocrinology, vol. 16, no. 1, 2020, pp. 32-39.
Bhattacharya S, Goyal A, Kaur P, et al. Anticancer Drug-induced Thyroid Dysfunction. Eur Endocrinol. 2020;16(1):32-39.
Bhattacharya, S., Goyal, A., Kaur, P., Singh, R., & Kalra, S. (2020). Anticancer Drug-induced Thyroid Dysfunction. European Endocrinology, 16(1), 32-39. https://doi.org/10.17925/EE.2020.16.1.32
Bhattacharya S, et al. Anticancer Drug-induced Thyroid Dysfunction. Eur Endocrinol. 2020;16(1):32-39. PubMed PMID: 32595767.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anticancer Drug-induced Thyroid Dysfunction. AU - Bhattacharya,Saptarshi, AU - Goyal,Alpesh, AU - Kaur,Parjeet, AU - Singh,Randeep, AU - Kalra,Sanjay, Y1 - 2020/02/04/ PY - 2019/09/12/received PY - 2019/11/08/accepted PY - 2020/6/30/entrez KW - Thyroid KW - anticancer drugs KW - hypothyroidism KW - immune checkpoint inhibitors KW - tyrosine kinase inhibitors SP - 32 EP - 39 JF - European endocrinology JO - Eur Endocrinol VL - 16 IS - 1 N2 - Cancer immunotherapy and targeted therapy, though less toxic than conventional chemotherapy, can increase the risk of thyroid dysfunction. Immune checkpoint inhibitors render the cancer cells susceptible to immune destruction, but also predispose to autoimmune disorders like primary hypothyroidism as well as central hypothyroidism secondary to hypophysitis. Tyrosine kinase inhibitors act by blocking vascular endothelial growth factor receptors and their downstream targets. Disruption of the vascular supply from the inhibition of endothelial proliferation damages not only cancer cells but also organs with high vascularity like the thyroid. Interferon-α, interleukin-2 and thalidomide analogues can cause thyroid dysfunction by immune modulation. Alemtuzumab, a monoclonal antibody directed against the cell surface glycoprotein CD52 causes Graves' disease during immune reconstitution. Metaiodobenzylguanidine, combined with 131-iodine, administered as a radiotherapeutic agent for tumours derived from neural crest cells, can cause primary hypothyroidism. Bexarotene can produce transient central hypothyroidism by altering the feedback effect of thyroid hormone on the pituitary gland. Thyroid dysfunction can be managed in the usual manner without a requirement for dose reduction or discontinuation of the implicated agent. This review aims to highlight the effect of various anticancer agents on thyroid function. Early recognition and appropriate management of thyroid disorders during cancer therapy will help to improve treatment outcomes. SN - 1758-3780 UR - https://www.unboundmedicine.com/medline/citation/32595767/Anticancer_Drug-induced_Thyroid_Dysfunction L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32595767/ DB - PRIME DP - Unbound Medicine ER -
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