PMID- 33112294
OWN - NLM
STAT- MEDLINE
DCOM- 20210112
LR  - 20210112
IS  - 1479-683X (Electronic)
IS  - 0804-4643 (Linking)
VI  - 184
IP  - 1
DP  - 2021 Jan
TI  - THERAPY OF ENDOCRINE DISEASE: Endocrine-metabolic effects of treatment with 
      multikinase inhibitors.
PG  - R29-R40
LID - EJE-20-0683 [pii]
LID - 10.1530/EJE-20-0683 [doi]
AB  - Tyrosine kinase inhibitors (TKIs) are emerging as potentially effective options 
      in the treatment of cancer, acting on the pathways involved in growth, avoidance 
      of apoptosis, invasiveness, angiogenesis, and local and distant spread. TKIs 
      induce significant adverse effects, that can negatively affect patients' quality 
      of life. The most common adverse events (AEs) include fatigue, hand-foot skin 
      reaction, decreased appetite, nausea, diarrhea, hypertension, vomiting, weight 
      loss, endocrinopaties and metabolic disorders. Patients in therapy with TKIs can 
      develop endocrine-metabolic disorders, including dyslipidemia (~50%), diabetes 
      (~15-40%), and dysthyroidism (~20%). In some cases, patients show an improved 
      glycemia or hypoglycemia. The effects of TKIs on adrenal or gonadal function are 
      still not completely known. It was shown a higher prevalence of subclinical 
      hypocortisolism in patients treated with imatinib, while an increase of cortisol 
      was reported in patients receiving vandetanib. Long-term treatment with imatinib 
      could impact significantly the ovarian reserve and embryo developmental capacity. 
      It is important to evaluate patients, measure glucose levels, and manage 
      hyperglycemia. Mild treatment-related hyperglycemia can be controlled modifying 
      the diet and with exercise, while grade 3 and 4 hyperglycemia can lead to dose 
      reductions and/or oral antihyperglycemic therapy. Regarding thyroid dysfunctions, 
      it is recommendable to measure the thyroid-stimulating hormone (TSH)/free 
      thyroxine (FT4) levels before starting the therapy, and every 3-4 weeks during 
      the first 6 months as changes in FT4 levels precede the changes in TSH by 3-6 
      weeks. Additional studies are necessary to definitely clarify the mechanism of 
      TKIs-induced endocrine-metabolic effects.
FAU - Fallahi, Poupak
AU  - Fallahi P
AD  - Department of Translational Research and New Technologies in Medicine and 
      Surgery, University of Pisa, Pisa, Italy.
FAU - Ferrari, Silvia Martina
AU  - Ferrari SM
AD  - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 
      Italy.
FAU - Elia, Giusy
AU  - Elia G
AD  - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 
      Italy.
FAU - Ragusa, Francesca
AU  - Ragusa F
AD  - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 
      Italy.
FAU - Paparo, Sabrina Rosaria
AU  - Paparo SR
AD  - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 
      Italy.
FAU - Camastra, Stefania
AU  - Camastra S
AD  - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 
      Italy.
FAU - Mazzi, Valeria
AU  - Mazzi V
AD  - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 
      Italy.
FAU - Miccoli, Mario
AU  - Miccoli M
AD  - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 
      Italy.
FAU - Benvenga, Salvatore
AU  - Benvenga S
AD  - Department of Clinical and Experimental Medicine, Section of Endocrinology.
AD  - Master Program on Childhood, Adolescent and Women's Endocrine Health, University 
      of Messina, Messina, Italy.
AD  - Interdepartmental Program on Molecular & Clinical Endocrinology, and Women's 
      Endocrine Health, University hospital, A.O.U. Policlinico Gaetano Martino, 
      Messina, Italy.
FAU - Antonelli, Alessandro
AU  - Antonelli A
AD  - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 
      Italy.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Eur J Endocrinol
JT  - European journal of endocrinology
JID - 9423848
RN  - 0 (Protein Kinase Inhibitors)
SB  - IM
MH  - Diabetes Mellitus/*chemically induced
MH  - Dyslipidemias/*chemically induced
MH  - Humans
MH  - Protein Kinase Inhibitors/*adverse effects/therapeutic use
MH  - Thyroid Diseases/*chemically induced
EDAT- 2020/10/29 06:00
MHDA- 2021/01/13 06:00
CRDT- 2020/10/28 12:10
PHST- 2020/06/19 00:00 [received]
PHST- 2020/10/20 00:00 [accepted]
PHST- 2020/10/29 06:00 [pubmed]
PHST- 2021/01/13 06:00 [medline]
PHST- 2020/10/28 12:10 [entrez]
AID - EJE-20-0683 [pii]
AID - 10.1530/EJE-20-0683 [doi]
PST - ppublish
SO  - Eur J Endocrinol. 2021 Jan;184(1):R29-R40. doi: 10.1530/EJE-20-0683.