Nephrotoxicity in advanced thyroid cancer treated with tyrosine kinase inhibitors: An update

Crit Rev Oncol Hematol. 2021 Dec:168:103533. doi: 10.1016/j.critrevonc.2021.103533. Epub 2021 Nov 19.

Abstract

Over the past decade, the prognosis of advanced thyroid cancer (TC) patients has dramatically improved thanks to the introduction of tyrosine kinase inhibitors (TKIs). Despite their effectiveness, these drugs are burdened with several side effects that can negatively affect quality of life and compromise therapy continuation. Among renal adverse events (RAEs), proteinuria is the most frequently reported in clinical trials and real-life experiences, especially during treatment with lenvatinib or cabozantinib. This peculiar toxicity is commonly associated with targeted therapies with anti-angiogenic activity, even if the mechanisms underlying its onset and progression are not entirely clear. RAEs should be early recognized and properly managed to avoid renal function worsening and life-threatening consequences. Aiming at providing a comprehensive summary that can help clinicians to identify and manage TKIs-related RAEs in TC patients, we reviewed the current evidence about this topic, from pathogenesis and potential risk factors to diagnosis and treatment.

Keywords: Adverse event; Proteinuria; Renal injury; Targeted therapy; Thyroid carcinoma.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Drug-Related Side Effects and Adverse Reactions*
  • Humans
  • Protein Kinase Inhibitors / adverse effects
  • Quality of Life
  • Thyroid Neoplasms* / drug therapy

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors