Cacciapuoti, Marianna (2021) Role of type 2 deiodinase in thyroid kinase inhibitors-induced systemic hypothyroidism. [Tesi di dottorato]
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| Tipologia del documento: | Tesi di dottorato |
|---|---|
| Lingua: | English |
| Titolo: | Role of type 2 deiodinase in thyroid kinase inhibitors-induced systemic hypothyroidism |
| Autori: | Autore Email Cacciapuoti, Marianna mar.cacciapuoti@gmail.com |
| Data: | 7 Giugno 2021 |
| Numero di pagine: | 48 |
| Istituzione: | Università degli Studi di Napoli Federico II |
| Dipartimento: | Medicina Clinica e Chirurgia |
| Dottorato: | Terapie avanzate biomediche e chirurgiche |
| Ciclo di dottorato: | 33 |
| Coordinatore del Corso di dottorato: | nome email Di Minno, Giovanni [non definito] |
| Tutor: | nome email Salvatore, Domenico [non definito] |
| Data: | 7 Giugno 2021 |
| Numero di pagine: | 48 |
| Parole chiave: | Thyroid cancer; thyroid kinase inhibitors; hypothyroidism |
| Settori scientifico-disciplinari del MIUR: | Area 06 - Scienze mediche > MED/13 - Endocrinologia |
| Depositato il: | 18 Giu 2021 12:25 |
| Ultima modifica: | 07 Giu 2023 10:38 |
| URI: | http://www.fedoa.unina.it/id/eprint/13785 |
Abstract
Thyroid cancer accounts for up to 95% of primary cancers involving the endocrine system. Papillary (PTC) and follicular (FTC) thyroid carcinomas arise from thyroid epithelial cells and together make up differentiated thyroid cancer (DTC) (1); Medullary thyroid carcinoma (MTC) arises from the parafollicular cells that produce calcitonin (2). Thyroid cancer typically has a good outcome following standard treatments, however thyroid cancers that persist or recur following these therapies have a poorer prognosis. 'Target therapy' with tyrosine kinase inhibitors (TKIs) represents an important therapeutic option for the treatment of advanced cases of radioiodine refractory (RAI-R) DTC, MTC and possibly for cases of poorly differentiated (PDTC) and anaplastic thyroid cancer (ATC). In the last few years, several TKIs have been tested for the treatment of advanced, progressive and RAI-R thyroid cancers and some of them have been recently approved for use in clinical practice: sorafenib and lenvatinib for DTC and PDTC; vandetanib and cabozantinib for MTC. Hypothyroidism is a common side effect during TKIs cancer treatment and occurs in patients that underwent total thyroidectomy for thyroid cancer and in patients treated with TKIs for other cancers and that not underwent thyroidectomy. The clinical relevance of hypothyroidism, the value of thyroid hormone replacement in individuals with abnormal TSH after TKI therapy, and the correct timing of replacement therapy is necessary to improve the therapies used and quality of life for patients with cancer. The etiology of hypothyroidism has not been determined. We aimed to describe tissutal hypothyroidism especially in the heart and to understand how the TKIs influence the activity of deiodinase. Elucidating the influence of TKIs in the deiodinase activity is crucial for avoid side effects and improve adherence and efficacy of therapy.
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