Why the study?
Data regarding the severity and prevalence of metabolic adverse events from multitarget kinase inhibitors are scarce, which may be significant in patients with improved survival.
Does lenvatinib alter glucose, lipid levels, and estimated cardiovascular risk in patients with advanced thyroid cancer?
Does lenvatinib alter glucose, lipid levels, and estimated cardiovascular risk in patients with advanced thyroid cancer?
Lenvatinib therapy in advanced thyroid cancer is associated with significant increases in total cholesterol, triglycerides, LDL cholesterol, and estimated cardiovascular risk, which correlate with tumor response.
Lenvatinib was associated with worsened lipids and higher estimated CV risk; leaves open need for prospective monitoring trials in MKI-treated patients.
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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Acitelli et al. (2024) studied this question.
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