Effects of lenvatinib on glucose, cholesterol, triglycerides and estimated cardiovascular risk in patients with advanced thyroid cancer

IF 3.7 3区医学 Q2 Medicine Endocrine Pub Date : 2024-09-17 DOI:10.1007/s12020-024-04003-y

E. Acitelli, A. Verrienti, M. Sponziello, V. Pecce, I. Minicocci, M. Macera, S. Barp, P. Lucia, G. Grani, C. Durante, M. Maranghi

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Abstract

Purpose

Multitarget kinase inhibitors (MKIs) are effective options in the treatment of cancer, significantly increasing the progression-free survival (PFS) of many tumors. Data about severity and prevalence of metabolic adverse events is scarce and may be significant in patients with a better survival. The aim of this study was to investigate glucose and lipids values of patients treated with lenvatinib. Secondary aims included evaluating changes in the estimated risk of cardiovascular disease and the relationship between metabolic alterations and tumor response to therapy.

Methods

A retrospective pilot study on 29 patients with advanced differentiated thyroid cancer was conducted. Clinical and biochemical characteristics were collected at the day of therapy initiation and follow up. The 10-year risk of cardiovascular disease was estimated with the SCORE2 and SCORE2-OP algorithms. Tumor burden change was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST).

Results

No differences in glucose values were observed. A significant increase in total cholesterol (208 ± 41 versus 245 ± 67 mg/dl), triglycerides (112 [interquartile range, 58–326] versus 157 [78–296] mg/dl), calculated LDL cholesterol (128 [66–204] versus 140 [81–308] mg/dl) and cardiovascular risk was observed from baseline to follow up. Furthermore, these parameters increase progressively with increasing tumor response to therapy.

Conclusions

Despite limitations, this study shows an association between the use of lenvatinib and the development of lipid alterations in patients with advanced thyroid cancer. However, further investigation is necessary for a more comprehensive understanding of the adverse metabolic profile of MKIs.

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来伐替尼对晚期甲状腺癌患者血糖、胆固醇、甘油三酯和估计心血管风险的影响

目的多靶点激酶抑制剂（MKIs）是治疗癌症的有效选择，可显著提高许多肿瘤的无进展生存期（PFS）。有关代谢不良事件的严重程度和发生率的数据很少，而这些数据对提高患者生存率可能具有重要意义。本研究旨在调查接受来伐替尼治疗的患者的血糖和血脂值。次要目的包括评估心血管疾病估计风险的变化以及代谢改变与肿瘤对治疗反应之间的关系。研究收集了开始治疗和随访时的临床和生化特征。采用SCORE2和SCORE2-OP算法估算10年心血管疾病风险。根据实体瘤反应评估标准（RECIST）评估肿瘤负荷的变化。总胆固醇（208 ± 41 对 245 ± 67 mg/dl）、甘油三酯（112 [四分位间范围，58-326] 对 157 [78-296] mg/dl）、计算出的低密度脂蛋白胆固醇（128 [66-204] 对 140 [81-308] mg/dl）和心血管风险从基线到随访期间均明显增加。此外，随着肿瘤对治疗反应的增加，这些参数也会逐渐增加。结论尽管存在局限性，但本研究表明，使用来伐替尼与晚期甲状腺癌患者血脂改变的发生有关。然而，要更全面地了解MKIs的不良代谢谱，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.