ECE2016 Guided Posters Endocrine Tumours (10 abstracts)
Thyroid dysfunction and ultrasonography features in patients with metastatic colorectal cancer treated with Regorafenib: preliminary results from a single centre prospective cohort study
Fabiana Pani 1 , Laura Orgiano 2 , Francesco Boi 1 , Elena Massa 2 , Clelia Madeddu 2 , Valeria Pusceddu 2 , Mario Scartozzi 2 & Stefano Mariotti 1
1Endocrine Unit, Department of Medical Sciences M.Aresu, University of Cagliari, Sardinia, Italy; 2Medical Oncology, Department of Medical Sciences M.Aresu, University of Cagliari, Sardinia, Italy.
Introduction: Regorafenib, a Tyrosine kinase inhibitor (TKI) recently approved for the treatment of metastatic colorectal cancer patients previously treated with fluoropyrimidine-based chemotherapy, VEGF and EGFR inhibitors, may, like others TKIs produce hypothyroidism, but this effect has not been systematically evaluated so far.
Description of methods: Prospective evaluation of thyroid function, autoimmunity and morphology during treatment with Regorafenib. From November 2015, 14 consecutive patients (four males and ten females; mean age 64±8.1) with metastatic colorectal cancer with comparable tumoral staging, normal thyroid function and no evidence of associated thyroid autoimmunity, were studied before and at monthly intervals after beginning Regorafenib at scheduled dose of 160 mg oral daily according to standard protocols. In all cases FT3, FT4, TSH and thyroid antibodies (TgAb and TPOAb) were measured together with clinical assessment and thyroid ultrasonography up to three months.
Results: Within 30 days of therapy, 6/14 patients (43%) became hypothyroid (TSH 5.8±3.1, range 7–18.5) and TPOAb (199 and 88 IU/ml) became detectable in two patients (14%), who also showed the highest serum TSH concentrations (18.5 and 11 mUI/l).Thyroid volume significantly decreased in 8 (57%) patients (from 9.2±2.1 ml before to 6.1±1.7 ml 2 months after Regorafenib, P<0.01 by paired Student t-test), together with the appearance of mild hypoechogenicity and a significant reduction of parenchymal thyroid vascularity (P< 0.05).
Conclusions: These preliminary data indicate that Regorafenib, similarly to other TKIs inhibitors, may rapidly cause rapidly hypothyroidism in about one half of patients, and probably trigger thyroid autoimmunity. Further studies are needed to characterize longer-term effects on thyroid function-autoimmunity and to assess whether hypothyroidism may have a prognostic value as a biomarker of clinical response.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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