Is there any relationship between imatinib mesylate medication and hypothalamic-pituitary-adrenal axis dysfunction?

Bilgir, Oktay; Kebapçılar, Levent; Bilgir, Ferda; Sarı, İ̇smail; Oner, P.; Karaca, Baysal; Alacacıoğlu, İnci

doi:10.1111/j.1742-1241.2008.01856.x

Cited by 25 publications

(17 citation statements)

References 34 publications

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“…Interferon and interleukins have been implicated for both primary and central hypothyroidism. Imatinib mesylate, a tyrosine kinase inhibitor used for the treatment of chronic myeloid leukemia and some sarcomas (GIST), has been shown to cause GHD and subclinical glucocorticoid deficiency in a significant number of patients on stimulation test [55,56]. mTOR inhibitors have been demonstrated to cause antiproliferative and radiosensitizing activity on pituitary adenoma cells, and rat GH3 or MMQ cell lines [57].…”

Section: Reviewmentioning

confidence: 99%

Radiotherapy-induced hypopituitarism: a review

Sathyapalan

Dixit

2012

Expert Review of Anticancer Therapy

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Hypopituitarism is a disorder caused by impaired hormonal secretions from the hypothalamic-pituitary axis. Radiotherapy is the most common cause of iatrogenic hypopituitarism. The hypothalamic-pituitary axis inadvertently gets irradiated in patients receiving prophylactic cranial radiotherapy for leukemia, total body irradiation and radiotherapy for intracranial, base skull, sinonasal and nasopharyngeal tumors. Radiation-induced hypopituitarism (RIH) is insidious, progressive and largely nonreversible. Mostly, RIH involves one hypothalamic-pituitary axis; however, multiple hormonal axes deficiency starts developing at higher doses. Although the clinical effects of the hypopituitarism are more profound in children and young adults, its implications in older adults are being increasingly recognized. The risk continues to persist or increase up to 10 years following radiation exposure. The clinical management of hypopituitarism is challenging both for the patients and healthcare providers. Here we have reviewed the scale of the problem, the risk factors and the management of RIH.

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Section: Reviewmentioning

confidence: 99%

Radiotherapy-induced hypopituitarism: a review

Sathyapalan

Dixit

2012

Expert Review of Anticancer Therapy

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“…Twelve (48%) of patients were defined as HPA deficient in this study (defined as a peak serum cortisol level <18 micrograms/dL measured 30 minutes after intravenous delivery of 1 microgram of ACTH), indicating an increased prevalence of subclinical glucocorticoid deficiency in patients receiving imatinib (Bilgir, et al 2010). The Food and Drug Administration drug approval summary cautions that although no overt clinically important adrenal suppression has been observed in patients taking sunitinib, subclinical toxicity may be unmasked by physiologic stress; therefore monitoring for adrenal insufficiency is recommended in patients undergoing stressors such as surgery, trauma or severe infection (Rock, et al 2007).…”

Section: Adrenal Insufficiencymentioning

confidence: 99%

Endocrine side effects of broad-acting kinase inhibitors

Lodish

Stratakis²

2010

Endocrine-Related Cancer

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Targeted therapy in oncology consists of drugs that specifically interfere with abnormal signaling pathways that are dysregulated in cancer cells. Tyrosine kinase inhibitors (TKIs) take advantage of unique oncogenes that are activated in certain types of cancer, and also target common mechanisms of growth, invasion, metastasis, and angiogenesis. However, many kinase inhibitors for cancer therapy are somewhat nonselective, and most have additional mechanisms of action at the cellular level, which are not completely understood. The use of these agents has increased our knowledge of important side effects, of which the practicing clinician must be aware. Recently, proposed endocrine-related side effects of these agents include alterations in thyroid function, bone metabolism, linear growth, gonadal function, fetal development, and glucose metabolism, and adrenal function. This review summarizes the most recent data on the endocrine side effects of TKIs.

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“…Bilgir et al. evaluated 25 adult patients receiving imatinib for CML by measuring basal cortisol levels, as well as by performing glucagon stimulation testing and low‐dose adrenocorticotropin testing . They found that two patients had low basal cortisol levels and did not respond appropriately to both stimulation tests.…”

Section: Introductionmentioning

confidence: 99%

Recognizing Endocrinopathies Associated With Tyrosine Kinase Inhibitor Therapy in Children With Chronic Myelogenous Leukemia

Samis

Lee

Zimmerman

et al. 2016

Pediatr Blood Cancer

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Side effects of tyrosine kinase inhibitor (TKI) treatment vary in children and adults with chronic myelogenous leukemia (CML). As children have a much longer life expectancy than adults, TKI therapy may continue for decades and with long-term consequences that differ from adults. Children may develop endocrinopathies related to "off-target" effects of TKIs, such as delayed growth, changes in bone metabolism, thyroid abnormalities, and effects on puberty and fertility. These endocrinopathies present additional challenges for pediatric patients with CML. This review critically evaluates the literature on long-term endocrine side effects of TKIs in the pediatric CML population and provides suggested recommendations.

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Is there any relationship between imatinib mesylate medication and hypothalamic-pituitary-adrenal axis dysfunction?

Cited by 25 publications

References 34 publications

Radiotherapy-induced hypopituitarism: a review

Radiotherapy-induced hypopituitarism: a review

Endocrine side effects of broad-acting kinase inhibitors

Recognizing Endocrinopathies Associated With Tyrosine Kinase Inhibitor Therapy in Children With Chronic Myelogenous Leukemia

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