Refining personalized diagnosis, treatment and exploitation of hypothyroidism related to solid nonthyroid cancer

Per Med. 2023 Jan;20(1):87-105. doi: 10.2217/pme-2022-0052. Epub 2022 Dec 1.

Abstract

Hypothyroidism in the setting of cancer is a puzzling entity due to the dual role of the thyroid hormones (TH) in cancer - promoting versus inhibitory - and the complexity of the hypothyroidism itself. The present review provides a comprehensive overview of the personalized approach to hypothyroidism in patients with solid nonthyroid cancer, focusing on current challenges, unmet needs and future perspectives. Major electronic databases were searched from January 2011 until March 2022. The milestones of the refinement of such a personalized approach are prompt diagnosis, proper TH replacement and development of interventions and/or pharmaceutical agents to exploit hypothyroidism or, on the contrary, TH replacement as an anticancer strategy. Further elucidation of the dual role of TH in cancer - especially of the interference of TH signaling with the hallmarks of cancer - is anticipated to inform decision-making and optimize patient selection.

Keywords: drug-induced hypothyroidism; genomic actions; hypothyroidism; levothyroxine; liothyronine; nongenomic actions; personalized medicine; solid nonthyroid cancer; thyroid hormone receptors; thyroid hormones.

Publication types

  • Review

MeSH terms

  • Drug Therapy, Combination
  • Hormone Replacement Therapy
  • Humans
  • Hypothyroidism* / diagnosis
  • Hypothyroidism* / drug therapy
  • Neoplasms*
  • Thyroxine / therapeutic use

Substances

  • Thyroxine