Challenges Associated with Tyrosine Kinase Inhibitor Therapy for Metastatic Thyroid Cancer
Table 1
Major adverse events associated with commercially available TKIs which have been studied in thyroid cancer.
Adverse event
Sorafenib (%)
Sunitinib (%)
Pazopanib (%)
Vandetanib (%)
All-grade
≥grade 3
All-grade
≥grade 3
All-grade
≥grade 3
All-grade
≥grade 3
Hypertension
17
4
30
12
40
4
33
9
CHF or LVEF decline
1.7
NR
13
3
<1%
NR
<1
NR
Proteinuria
NR
NR
NR
NR
9
<1
10
0
Hand-foot skin reaction
30
6
29
6
6
NR
NR
NR
Stomatitis
NR
NR
30
1
4
NR
NR
NR
Anorexia
16
<1
34
2
22
2
21
4
Weight loss
10
<1
12
<1
52
3.5
10
1
Diarrhea
43
2
61
9
52
3.5
57
11
AST elevation
NR
NR
56
2
53
7.5
NR
NR
ALT elevation
NR
NR
51
2.5
53
12
51
2
Fatigue
37
5
54
11
19
2
24
6
Hypothyroidism
NR
NR
14
2
7
NR
NR
NR
Arterial thromboembolism
2.9
NR
NR
NR
3
2
NR
NR
Hemorrhage/bleeding (all sites)
15
3
30
3
13
2
NR
NR
CHF: congestive heart failure; LVEF: left ventricular ejection fraction; AST: aspartate aminotransferase; ALT: alanine aminotransferase; NR: not reported. Data extracted from the phase 3 trials or from the prescribing drug reference information [9, 28–30]. Table is adapted from [31].