Reach further, in an Open Access Journal Endocrinology, Diabetes & Metabolism Case Reports

ISSN 1470-3947 (print)
ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology

Published by BioScientifica
Endocrine Abstracts (2010) 22 P423 

Reversible heart failure after sorafenib administration in advanced metastatic differentiated thyroid carcinoma (DTC)

Massimo Giusti1, Maria Derchi2, Lorenzo Mortara1, Mario Canepa2, Francesca Cecoli1, Francesco Minuto1 & Paolo Spallarossa2

Author affiliations

Sorafenib (S) is a reasonably well-tolerated therapy in DTC. A large number of side-effects have been reported. We report our data on the effectiveness and tolerability of S in 6 patients with advanced metastatic epithelial (2 follicular, 1 papillary, 1 insular) and medullary DTCs (52–79 years). In all patients, heart function was evaluated before and during S administration (400 mg/day) together with the objective response rate and changes in serum markers. Underlying heart function, clinical examination, EKG, echocardiographic assessment and N-terminal type-B natriuretic peptide (NT-proBNP) and troponin I levels were recorded before therapy, on therapy and after S discontinuation. Hypertension was found in 50% of patients before therapy; in these patients, hypotensive treatment did not change on therapy. In 2 of the remaining patients, hypotensive therapy was started after a 1-month period of S. S therapy was discontinued in 3 cases owing to: disease progression after a 6-month period of stable disease; patient request due to mucositis and skin rash after 3 months; and severe heart failure (NYHA class 4) after 3 months. No patients showed changes in troponin I levels. NT-proBNP levels sharply increased in a previously normotensive patient with insular cancer after 2 months on S, when heart failure begun. A slight NT-proBNP increases was seen in 2 further subjects. The table reports some of the echo-cardiographic variables measured. In case 4, heart function returned to pre-S levels in the 6-month after S discontinuation and BP normalized on hypotensive therapy.

#Shortening fraction (%)Ejection fraction (%)

Our data seem to indicate a decrease in tumor markers and a partial response in 66% of subjects during a 3–6 month course of S. Hypertension and severe heart failure may occur but they are not associated with cardiomyocyte death and are reversible side-effects. Heart function should be carefully monitored during S therapy in thyroid cancer patients.

This Issue/Conference

Article tools

My recent searches