Endocrine Effects of the Tyrosine Kinase Inhibitor Vandetanib in Patients Treated for Thyroid Cancer
Purpose: The purpose of the study was to assess the endocrine effects of vandetanib, a multikinase inhibitor targeting RET, vascular endothelial growth factor receptor, and epidermal growth factor receptor, in 39 patients with progressive thyroid cancer included in two randomized placebo-controlled...
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| creator | Brassard, Maryse Neraud, Barbara Trabado, Séverine Salenave, Sylvie Brailly-Tabard, Sylvie Borget, Isabelle Baudin, Eric Leboulleux, Sophie Chanson, Philippe Schlumberger, Martin Young, Jacques |
| description | Purpose:
The purpose of the study was to assess the endocrine effects of vandetanib, a multikinase inhibitor targeting RET, vascular endothelial growth factor receptor, and epidermal growth factor receptor, in 39 patients with progressive thyroid cancer included in two randomized placebo-controlled trials using vandetanib 300 mg/d.
Methods:
Endocrine samplings were performed at baseline and then every 6 months. We compared differences in endocrine parameters between baseline and on vandetanib therapy or placebo.
Results:
During vandetanib treatment, several changes were observed. 1) Calcium (P = 0.0004) and vitamin D (P = 0.001) mean replacement doses were increased; calcium level remained unchanged, but serum 25(OH) vitamin D level decreased (P = 0.001); and serum PTH (P = 0.01) and 1,25(OH)2 vitamin D (P = 0.01) levels increased, suggesting a decreased intestinal absorption of vitamin D or lack of sun exposure as a result of photosensitization. 2) l-T4 doses were increased (P < 0.0001) to maintain serum TSH within the normal range. 3) In male patients, total testosterone (P = 0.048), bioavailable testosterone (P = 0.03), and SHBG (P = 0.02) levels increased. Serum inhibin B decreased (P = 0.02) and stimulated FSH increased (P = 0.006), suggesting a Sertoli cells insufficiency. 4) Cortisol level increased (P = 0.007) as well as ACTH level (P = 0.03) and cortisol-binding globulin (P = 0.02), but free urinary cortisol levels remained in the normal range. None of these changes were observed in patients randomized to the placebo arm.
Conclusion:
In patients with locally advanced or metastatic thyroid cancer, the tyrosine kinase inhibitor vandetanib has several endocrine effects. Thyroid hormone, calcium, and vitamin D analog requirements increased, but consequences of the biological alterations on phosphocalcic metabolism and gonadotrope and adrenal functions are unknown. |
| doi_str_mv | 10.1210/jc.2010-2771 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_888089375</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1210/jc.2010-2771</oup_id><sourcerecordid>3164455951</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5075-fbd27f05afa4b5b43bd74c4935a1d3ba0e1cb0c6c0b0bdaadb019cc303fe94cf3</originalsourceid><addsrcrecordid>eNp1kU2LEzEYgAdR3Lp68ywBES_O-maSNJ3jUqouLuihireQjzdM6jRTkxmW_fdmaNeCaCCEhOf9elJVLylc0YbC-529aoBC3UhJH1UL2nJRS9rKx9UCoKF1K5sfF9WznHcAlHPBnlYXDZVUCCYXldtEN9gUIpKN92jHTAZPxg7J9j4NeX7_HKLOSG5iF0wYh0S-6-hw1DEYEiL5qseAscRtE-oRHfEF2XYlOjiy1tFiel498brP-OJ0XlbfPmy260_17ZePN-vr29oKkKL2xjXSg9BecyMMZ8ZJbnnLhKaOGQ1IrQG7tGDAOK2dAdpay4B5bLn17LJ6e8x7SMOvCfOo9iFb7HsdcZiyWq1WsGqZFIV8_Re5G6YUS3OK0WWxJFpBC_XuSNmiIif06pDCXqd7RUHN8tXOqlm-muUX_NUp6WT26P7AD7YL8OYE6Gx171OxE_KZ4wKoWM6J-JG7G_oRU_7ZT3eYVIe6HzsFZfGlXNWlMoW23OqyqTiPP0yH_3VanzplRxIffv-QMOezhH_O9xuhmLls</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3164455951</pqid></control><display><type>article</type><title>Endocrine Effects of the Tyrosine Kinase Inhibitor Vandetanib in Patients Treated for Thyroid Cancer</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><source>Journals@Ovid Complete</source><creator>Brassard, Maryse ; Neraud, Barbara ; Trabado, Séverine ; Salenave, Sylvie ; Brailly-Tabard, Sylvie ; Borget, Isabelle ; Baudin, Eric ; Leboulleux, Sophie ; Chanson, Philippe ; Schlumberger, Martin ; Young, Jacques</creator><creatorcontrib>Brassard, Maryse ; Neraud, Barbara ; Trabado, Séverine ; Salenave, Sylvie ; Brailly-Tabard, Sylvie ; Borget, Isabelle ; Baudin, Eric ; Leboulleux, Sophie ; Chanson, Philippe ; Schlumberger, Martin ; Young, Jacques</creatorcontrib><description>Purpose:
The purpose of the study was to assess the endocrine effects of vandetanib, a multikinase inhibitor targeting RET, vascular endothelial growth factor receptor, and epidermal growth factor receptor, in 39 patients with progressive thyroid cancer included in two randomized placebo-controlled trials using vandetanib 300 mg/d.
Methods:
Endocrine samplings were performed at baseline and then every 6 months. We compared differences in endocrine parameters between baseline and on vandetanib therapy or placebo.
Results:
During vandetanib treatment, several changes were observed. 1) Calcium (P = 0.0004) and vitamin D (P = 0.001) mean replacement doses were increased; calcium level remained unchanged, but serum 25(OH) vitamin D level decreased (P = 0.001); and serum PTH (P = 0.01) and 1,25(OH)2 vitamin D (P = 0.01) levels increased, suggesting a decreased intestinal absorption of vitamin D or lack of sun exposure as a result of photosensitization. 2) l-T4 doses were increased (P < 0.0001) to maintain serum TSH within the normal range. 3) In male patients, total testosterone (P = 0.048), bioavailable testosterone (P = 0.03), and SHBG (P = 0.02) levels increased. Serum inhibin B decreased (P = 0.02) and stimulated FSH increased (P = 0.006), suggesting a Sertoli cells insufficiency. 4) Cortisol level increased (P = 0.007) as well as ACTH level (P = 0.03) and cortisol-binding globulin (P = 0.02), but free urinary cortisol levels remained in the normal range. None of these changes were observed in patients randomized to the placebo arm.
Conclusion:
In patients with locally advanced or metastatic thyroid cancer, the tyrosine kinase inhibitor vandetanib has several endocrine effects. Thyroid hormone, calcium, and vitamin D analog requirements increased, but consequences of the biological alterations on phosphocalcic metabolism and gonadotrope and adrenal functions are unknown.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2010-2771</identifier><identifier>PMID: 21715537</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Adenocarcinoma, Follicular - blood ; Adenocarcinoma, Follicular - drug therapy ; Adenocarcinoma, Papillary - blood ; Adenocarcinoma, Papillary - drug therapy ; Adrenocorticotropic hormone ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Blood Glucose ; Calcium - blood ; Calcium metabolism ; Clinical trials ; Cortisol ; Cross-Over Studies ; Endocrinopathies ; Enzyme Inhibitors - therapeutic use ; ErbB Receptors - antagonists & inhibitors ; Feeding. Feeding behavior ; Female ; Follicle-stimulating hormone ; Fundamental and applied biological sciences. Psychology ; Globulins ; Growth factors ; Hormones ; Humans ; Inhibin ; Intestinal absorption ; Male ; Malignant tumors ; Medical sciences ; Metastases ; Middle Aged ; Parathyroid hormone ; Parathyroid Hormone - blood ; Photosensitization ; Piperidines - therapeutic use ; Pituitary (anterior) ; Placebos ; Proto-Oncogene Proteins c-ret - antagonists & inhibitors ; Quinazolines - therapeutic use ; Receptors, Vascular Endothelial Growth Factor - antagonists & inhibitors ; Ret protein ; Sertoli cells ; Testosterone ; Testosterone - blood ; Thyroid cancer ; Thyroid Neoplasms - drug therapy ; Thyroid-stimulating hormone ; Thyroid. Thyroid axis (diseases) ; Thyroxine ; Treatment Outcome ; Tyrosine kinase inhibitors ; Vascular endothelial growth factor ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology ; Vitamin D ; Vitamin D - blood</subject><ispartof>The journal of clinical endocrinology and metabolism, 2011-09, Vol.96 (9), p.2741-2749</ispartof><rights>Copyright © 2011 by The Endocrine Society</rights><rights>Copyright © 2011 by The Endocrine Society 2011</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5075-fbd27f05afa4b5b43bd74c4935a1d3ba0e1cb0c6c0b0bdaadb019cc303fe94cf3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24501561$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21715537$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brassard, Maryse</creatorcontrib><creatorcontrib>Neraud, Barbara</creatorcontrib><creatorcontrib>Trabado, Séverine</creatorcontrib><creatorcontrib>Salenave, Sylvie</creatorcontrib><creatorcontrib>Brailly-Tabard, Sylvie</creatorcontrib><creatorcontrib>Borget, Isabelle</creatorcontrib><creatorcontrib>Baudin, Eric</creatorcontrib><creatorcontrib>Leboulleux, Sophie</creatorcontrib><creatorcontrib>Chanson, Philippe</creatorcontrib><creatorcontrib>Schlumberger, Martin</creatorcontrib><creatorcontrib>Young, Jacques</creatorcontrib><title>Endocrine Effects of the Tyrosine Kinase Inhibitor Vandetanib in Patients Treated for Thyroid Cancer</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Purpose:
The purpose of the study was to assess the endocrine effects of vandetanib, a multikinase inhibitor targeting RET, vascular endothelial growth factor receptor, and epidermal growth factor receptor, in 39 patients with progressive thyroid cancer included in two randomized placebo-controlled trials using vandetanib 300 mg/d.
Methods:
Endocrine samplings were performed at baseline and then every 6 months. We compared differences in endocrine parameters between baseline and on vandetanib therapy or placebo.
Results:
During vandetanib treatment, several changes were observed. 1) Calcium (P = 0.0004) and vitamin D (P = 0.001) mean replacement doses were increased; calcium level remained unchanged, but serum 25(OH) vitamin D level decreased (P = 0.001); and serum PTH (P = 0.01) and 1,25(OH)2 vitamin D (P = 0.01) levels increased, suggesting a decreased intestinal absorption of vitamin D or lack of sun exposure as a result of photosensitization. 2) l-T4 doses were increased (P < 0.0001) to maintain serum TSH within the normal range. 3) In male patients, total testosterone (P = 0.048), bioavailable testosterone (P = 0.03), and SHBG (P = 0.02) levels increased. Serum inhibin B decreased (P = 0.02) and stimulated FSH increased (P = 0.006), suggesting a Sertoli cells insufficiency. 4) Cortisol level increased (P = 0.007) as well as ACTH level (P = 0.03) and cortisol-binding globulin (P = 0.02), but free urinary cortisol levels remained in the normal range. None of these changes were observed in patients randomized to the placebo arm.
Conclusion:
In patients with locally advanced or metastatic thyroid cancer, the tyrosine kinase inhibitor vandetanib has several endocrine effects. Thyroid hormone, calcium, and vitamin D analog requirements increased, but consequences of the biological alterations on phosphocalcic metabolism and gonadotrope and adrenal functions are unknown.</description><subject>Adenocarcinoma, Follicular - blood</subject><subject>Adenocarcinoma, Follicular - drug therapy</subject><subject>Adenocarcinoma, Papillary - blood</subject><subject>Adenocarcinoma, Papillary - drug therapy</subject><subject>Adrenocorticotropic hormone</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose</subject><subject>Calcium - blood</subject><subject>Calcium metabolism</subject><subject>Clinical trials</subject><subject>Cortisol</subject><subject>Cross-Over Studies</subject><subject>Endocrinopathies</subject><subject>Enzyme Inhibitors - therapeutic use</subject><subject>ErbB Receptors - antagonists & inhibitors</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Follicle-stimulating hormone</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Globulins</subject><subject>Growth factors</subject><subject>Hormones</subject><subject>Humans</subject><subject>Inhibin</subject><subject>Intestinal absorption</subject><subject>Male</subject><subject>Malignant tumors</subject><subject>Medical sciences</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Parathyroid hormone</subject><subject>Parathyroid Hormone - blood</subject><subject>Photosensitization</subject><subject>Piperidines - therapeutic use</subject><subject>Pituitary (anterior)</subject><subject>Placebos</subject><subject>Proto-Oncogene Proteins c-ret - antagonists & inhibitors</subject><subject>Quinazolines - therapeutic use</subject><subject>Receptors, Vascular Endothelial Growth Factor - antagonists & inhibitors</subject><subject>Ret protein</subject><subject>Sertoli cells</subject><subject>Testosterone</subject><subject>Testosterone - blood</subject><subject>Thyroid cancer</subject><subject>Thyroid Neoplasms - drug therapy</subject><subject>Thyroid-stimulating hormone</subject><subject>Thyroid. Thyroid axis (diseases)</subject><subject>Thyroxine</subject><subject>Treatment Outcome</subject><subject>Tyrosine kinase inhibitors</subject><subject>Vascular endothelial growth factor</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><subject>Vitamin D</subject><subject>Vitamin D - blood</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU2LEzEYgAdR3Lp68ywBES_O-maSNJ3jUqouLuihireQjzdM6jRTkxmW_fdmaNeCaCCEhOf9elJVLylc0YbC-529aoBC3UhJH1UL2nJRS9rKx9UCoKF1K5sfF9WznHcAlHPBnlYXDZVUCCYXldtEN9gUIpKN92jHTAZPxg7J9j4NeX7_HKLOSG5iF0wYh0S-6-hw1DEYEiL5qseAscRtE-oRHfEF2XYlOjiy1tFiel498brP-OJ0XlbfPmy260_17ZePN-vr29oKkKL2xjXSg9BecyMMZ8ZJbnnLhKaOGQ1IrQG7tGDAOK2dAdpay4B5bLn17LJ6e8x7SMOvCfOo9iFb7HsdcZiyWq1WsGqZFIV8_Re5G6YUS3OK0WWxJFpBC_XuSNmiIif06pDCXqd7RUHN8tXOqlm-muUX_NUp6WT26P7AD7YL8OYE6Gx171OxE_KZ4wKoWM6J-JG7G_oRU_7ZT3eYVIe6HzsFZfGlXNWlMoW23OqyqTiPP0yH_3VanzplRxIffv-QMOezhH_O9xuhmLls</recordid><startdate>201109</startdate><enddate>201109</enddate><creator>Brassard, Maryse</creator><creator>Neraud, Barbara</creator><creator>Trabado, Séverine</creator><creator>Salenave, Sylvie</creator><creator>Brailly-Tabard, Sylvie</creator><creator>Borget, Isabelle</creator><creator>Baudin, Eric</creator><creator>Leboulleux, Sophie</creator><creator>Chanson, Philippe</creator><creator>Schlumberger, Martin</creator><creator>Young, Jacques</creator><general>Endocrine Society</general><general>Oxford University Press</general><general>Copyright by The Endocrine Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201109</creationdate><title>Endocrine Effects of the Tyrosine Kinase Inhibitor Vandetanib in Patients Treated for Thyroid Cancer</title><author>Brassard, Maryse ; Neraud, Barbara ; Trabado, Séverine ; Salenave, Sylvie ; Brailly-Tabard, Sylvie ; Borget, Isabelle ; Baudin, Eric ; Leboulleux, Sophie ; Chanson, Philippe ; Schlumberger, Martin ; Young, Jacques</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5075-fbd27f05afa4b5b43bd74c4935a1d3ba0e1cb0c6c0b0bdaadb019cc303fe94cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adenocarcinoma, Follicular - blood</topic><topic>Adenocarcinoma, Follicular - drug therapy</topic><topic>Adenocarcinoma, Papillary - blood</topic><topic>Adenocarcinoma, Papillary - drug therapy</topic><topic>Adrenocorticotropic hormone</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose</topic><topic>Calcium - blood</topic><topic>Calcium metabolism</topic><topic>Clinical trials</topic><topic>Cortisol</topic><topic>Cross-Over Studies</topic><topic>Endocrinopathies</topic><topic>Enzyme Inhibitors - therapeutic use</topic><topic>ErbB Receptors - antagonists & inhibitors</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Follicle-stimulating hormone</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Globulins</topic><topic>Growth factors</topic><topic>Hormones</topic><topic>Humans</topic><topic>Inhibin</topic><topic>Intestinal absorption</topic><topic>Male</topic><topic>Malignant tumors</topic><topic>Medical sciences</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Parathyroid hormone</topic><topic>Parathyroid Hormone - blood</topic><topic>Photosensitization</topic><topic>Piperidines - therapeutic use</topic><topic>Pituitary (anterior)</topic><topic>Placebos</topic><topic>Proto-Oncogene Proteins c-ret - antagonists & inhibitors</topic><topic>Quinazolines - therapeutic use</topic><topic>Receptors, Vascular Endothelial Growth Factor - antagonists & inhibitors</topic><topic>Ret protein</topic><topic>Sertoli cells</topic><topic>Testosterone</topic><topic>Testosterone - blood</topic><topic>Thyroid cancer</topic><topic>Thyroid Neoplasms - drug therapy</topic><topic>Thyroid-stimulating hormone</topic><topic>Thyroid. Thyroid axis (diseases)</topic><topic>Thyroxine</topic><topic>Treatment Outcome</topic><topic>Tyrosine kinase inhibitors</topic><topic>Vascular endothelial growth factor</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><topic>Vitamin D</topic><topic>Vitamin D - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brassard, Maryse</creatorcontrib><creatorcontrib>Neraud, Barbara</creatorcontrib><creatorcontrib>Trabado, Séverine</creatorcontrib><creatorcontrib>Salenave, Sylvie</creatorcontrib><creatorcontrib>Brailly-Tabard, Sylvie</creatorcontrib><creatorcontrib>Borget, Isabelle</creatorcontrib><creatorcontrib>Baudin, Eric</creatorcontrib><creatorcontrib>Leboulleux, Sophie</creatorcontrib><creatorcontrib>Chanson, Philippe</creatorcontrib><creatorcontrib>Schlumberger, Martin</creatorcontrib><creatorcontrib>Young, Jacques</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brassard, Maryse</au><au>Neraud, Barbara</au><au>Trabado, Séverine</au><au>Salenave, Sylvie</au><au>Brailly-Tabard, Sylvie</au><au>Borget, Isabelle</au><au>Baudin, Eric</au><au>Leboulleux, Sophie</au><au>Chanson, Philippe</au><au>Schlumberger, Martin</au><au>Young, Jacques</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endocrine Effects of the Tyrosine Kinase Inhibitor Vandetanib in Patients Treated for Thyroid Cancer</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2011-09</date><risdate>2011</risdate><volume>96</volume><issue>9</issue><spage>2741</spage><epage>2749</epage><pages>2741-2749</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>Purpose:
The purpose of the study was to assess the endocrine effects of vandetanib, a multikinase inhibitor targeting RET, vascular endothelial growth factor receptor, and epidermal growth factor receptor, in 39 patients with progressive thyroid cancer included in two randomized placebo-controlled trials using vandetanib 300 mg/d.
Methods:
Endocrine samplings were performed at baseline and then every 6 months. We compared differences in endocrine parameters between baseline and on vandetanib therapy or placebo.
Results:
During vandetanib treatment, several changes were observed. 1) Calcium (P = 0.0004) and vitamin D (P = 0.001) mean replacement doses were increased; calcium level remained unchanged, but serum 25(OH) vitamin D level decreased (P = 0.001); and serum PTH (P = 0.01) and 1,25(OH)2 vitamin D (P = 0.01) levels increased, suggesting a decreased intestinal absorption of vitamin D or lack of sun exposure as a result of photosensitization. 2) l-T4 doses were increased (P < 0.0001) to maintain serum TSH within the normal range. 3) In male patients, total testosterone (P = 0.048), bioavailable testosterone (P = 0.03), and SHBG (P = 0.02) levels increased. Serum inhibin B decreased (P = 0.02) and stimulated FSH increased (P = 0.006), suggesting a Sertoli cells insufficiency. 4) Cortisol level increased (P = 0.007) as well as ACTH level (P = 0.03) and cortisol-binding globulin (P = 0.02), but free urinary cortisol levels remained in the normal range. None of these changes were observed in patients randomized to the placebo arm.
Conclusion:
In patients with locally advanced or metastatic thyroid cancer, the tyrosine kinase inhibitor vandetanib has several endocrine effects. Thyroid hormone, calcium, and vitamin D analog requirements increased, but consequences of the biological alterations on phosphocalcic metabolism and gonadotrope and adrenal functions are unknown.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>21715537</pmid><doi>10.1210/jc.2010-2771</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The journal of clinical endocrinology and metabolism, 2011-09, Vol.96 (9), p.2741-2749 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Adenocarcinoma, Follicular - blood Adenocarcinoma, Follicular - drug therapy Adenocarcinoma, Papillary - blood Adenocarcinoma, Papillary - drug therapy Adrenocorticotropic hormone Adult Aged Aged, 80 and over Biological and medical sciences Blood Glucose Calcium - blood Calcium metabolism Clinical trials Cortisol Cross-Over Studies Endocrinopathies Enzyme Inhibitors - therapeutic use ErbB Receptors - antagonists & inhibitors Feeding. Feeding behavior Female Follicle-stimulating hormone Fundamental and applied biological sciences. Psychology Globulins Growth factors Hormones Humans Inhibin Intestinal absorption Male Malignant tumors Medical sciences Metastases Middle Aged Parathyroid hormone Parathyroid Hormone - blood Photosensitization Piperidines - therapeutic use Pituitary (anterior) Placebos Proto-Oncogene Proteins c-ret - antagonists & inhibitors Quinazolines - therapeutic use Receptors, Vascular Endothelial Growth Factor - antagonists & inhibitors Ret protein Sertoli cells Testosterone Testosterone - blood Thyroid cancer Thyroid Neoplasms - drug therapy Thyroid-stimulating hormone Thyroid. Thyroid axis (diseases) Thyroxine Treatment Outcome Tyrosine kinase inhibitors Vascular endothelial growth factor Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology Vitamin D Vitamin D - blood |
| title | Endocrine Effects of the Tyrosine Kinase Inhibitor Vandetanib in Patients Treated for Thyroid Cancer |
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