The Adverse Effect of Hypertension in the Treatment of Thyroid Cancer with Multi-Kinase Inhibitors

Abstract

Abstract:The treatment of thyroid cancer has promising prospects, mostly through the use of surgical or radioactive iodine therapy. However, some thyroid cancers, such as progressive radioactive iodine-refractory differentiated thyroid carcinoma, are not remediable with conventional types of treatment. In these cases, a treatment regimen with multi-kinase inhibitors is advisable. Unfortunately, clinical trials have shown a large number of patients, treated with multi-kinase inhibitors, being adversely affected by hypertension. This means that treatment of thyroid cancer with multi-kinase inhibitors prolongs progression-free and overall survival of patients, but a large number of patients experience hypertension as an adverse effect of the treatment. Whether the prolonged lifetime is sufficient to develop sequelae from hypertension is unclear, but late-stage cancer patients often have additional diseases, which can be complicated by the presence of hypertension. Since the exact mechanisms of the rise of hypertension in these patients are still unknown, the only available strategy is treating the symptoms. More studies determining the pathogenesis of hypertension as a side effect to cancer treatment as well as outcomes of dose management of cancer drugs are necessary to improve future therapy options for hypertension as an adverse effect to cancer therapy with multi-kinase inhibitors.

Multikinase Inhibitor Treatment in Thyroid Cancer

“…The studies included substantiated the importance of focusing on AEs given the prevalence of AEs ranging from 87.2% to 100%. It is well known that MKIs cause AEs, with proteinuria, diarrhea, hypertension, and palmar-plantar erythrodysesthesia syndrome being some of the most common [55,56]. The AEs play a substantial part in the treatment with MKIs.…”

Novel Therapies Against Aggressive Differentiated Thyroid Carcinomas

“…The assessment of AEs should comprehend severity scales like the common terminology criteria for AEs since this may help to assist in treatment reductions/withdrawals [39]. Table 2 describes the most common AEs and strategies to manage them [11,[40][41][42][43][44][45].…”

Current Knowledge in Thyroid Cancer—From Bench to Bedside

“…Several manuscripts focusing on the diagnosis [ 11 , 12 , 13 , 14 , 15 ], characterisation [ 16 , 17 , 18 , 19 ], and treatment [ 20 , 21 , 22 ] of thyroid cancer, as well as on alterations of thyroid cancer cells by altered gravity [ 23 , 24 ] or radiation damage of the thyroid gland [ 25 ], including genetics, proteomics, molecular, and cell biology, are published in this Special Issue. In addition, an original publication reports that the polymorphism loci of the tumour necrosis factor superfamily member 4 ( TNFSF4 ) gene is related to early-onset autoimmune thyroid diseases [ 26 ].…”

“…This Special Issue also covered studies on patients, providing novel mechanistic insights into the thyroid cancer pathogenesis and new aspects that may impact diagnosis or clinical therapy. Recent study results in order to review the current status of new therapy options in thyroid cancer were published [ 20 , 21 ].…”

“…Unfortunately, these drugs have adverse effects. The adverse effect of hypertension in the treatment of thyroid cancer with multi-kinase inhibitors (MKI), was reviewed by Ancker et al [ 21 ]. Clinical trials have shown that a large number of thyroid cancer patients treated with MKI were affected by hypertension [ 21 ].…”