Prognostic Value of Thyroid Hormone Ratio in Patients With Advanced Metastatic Renal Cell Carcinoma: Results From the Threefour Study (Meet-URO 14).

FT3/FT4 deiodination immunotherapy progression renal cell carcinoma survival tyrosine kinase inhibitors

Journal

Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867

Informations de publication

Date de publication:
2021
Historique:
received: 01 10 2021
accepted: 03 11 2021
entrez: 13 12 2021
pubmed: 14 12 2021
medline: 14 12 2021
Statut: epublish

Résumé

Thyroid hormone impairment, represented as an alteration in levels of thyroid hormones and a lower fT3/fT4 ratio, has been correlated with a worse prognosis for both cancer and non-cancer patients. The role of baseline thyroid function in patients with metastatic renal cell carcinoma (mRCC) however, has not been studied yet. We recorded clinical data, baseline biochemical results, and oncological outcomes from 10 Oncology Units in Italy. We stratified patients into three groups according to the fT3/fT4 ratio value and subsequently analyzed differences in progression-free survival (PFS) and overall survival (OS) in the three groups. We also performed univariate and multivariate analyses to find prognostic factors for PFS and OS. We analyzed 134 patients treated with systemic treatment for mRCC. Median PFS in the low, intermediate, and high fT3/fT4 ratio group were 7.5, 12.1, and 21.7 months respectively (p<0.001); median OS in the three groups were 36.5, 48.6, and 70.5 months respectively (p =0.006). The low fT3/fT4 ratio maintained its prognostic role at the multivariate analysis independently from IMDC and other well-established prognostic factors. The development of iatrogenic hypothyroidism was not associated with a better outcome. We found that baseline thyroid hormone impairment, represented by a low fT3/fT4 ratio, is a strong prognostic factor in patients treated for mRCC in first line setting and is independent of other parameters currently used in clinical practice.

Sections du résumé

BACKGROUND BACKGROUND
Thyroid hormone impairment, represented as an alteration in levels of thyroid hormones and a lower fT3/fT4 ratio, has been correlated with a worse prognosis for both cancer and non-cancer patients. The role of baseline thyroid function in patients with metastatic renal cell carcinoma (mRCC) however, has not been studied yet.
MATERIALS AND METHODS METHODS
We recorded clinical data, baseline biochemical results, and oncological outcomes from 10 Oncology Units in Italy. We stratified patients into three groups according to the fT3/fT4 ratio value and subsequently analyzed differences in progression-free survival (PFS) and overall survival (OS) in the three groups. We also performed univariate and multivariate analyses to find prognostic factors for PFS and OS.
RESULTS RESULTS
We analyzed 134 patients treated with systemic treatment for mRCC. Median PFS in the low, intermediate, and high fT3/fT4 ratio group were 7.5, 12.1, and 21.7 months respectively (p<0.001); median OS in the three groups were 36.5, 48.6, and 70.5 months respectively (p =0.006). The low fT3/fT4 ratio maintained its prognostic role at the multivariate analysis independently from IMDC and other well-established prognostic factors. The development of iatrogenic hypothyroidism was not associated with a better outcome.
CONCLUSION CONCLUSIONS
We found that baseline thyroid hormone impairment, represented by a low fT3/fT4 ratio, is a strong prognostic factor in patients treated for mRCC in first line setting and is independent of other parameters currently used in clinical practice.

Identifiants

pubmed: 34900742
doi: 10.3389/fonc.2021.787835
pmc: PMC8655227
doi:

Types de publication

Journal Article

Langues

eng

Pagination

787835

Informations de copyright

Copyright © 2021 Maruzzo, Verzoni, Vitale, Dionese, Buti, Galli, Zivi, Watutantrige-Fernando, Zielli, Zanardi, Sabbatini, Basso, Zagonel and Procopio.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Marco Maruzzo (M)

Oncology Unit 1, Istituto Oncologico Veneto, IOV - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy.

Elena Verzoni (E)

Genito-Urinary (GU) Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Istituto Nazionale dei Tumori, Milano, Italy.

Maria Giuseppa Vitale (MG)

Oncology Unit, Azienda Ospedaliera Universitaria di Modena, Modena, Italy.

Michele Dionese (M)

Oncology Unit 1, Istituto Oncologico Veneto, IOV - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy.
Dipartimento di Scienze Chirurgiche Oncologiche e Gastroenterologiche, Università degli Studi di Padova, Padova, Italy.

Sebastiano Buti (S)

Oncology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.

Luca Galli (L)

Oncology Unit, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.

Andrea Zivi (A)

Oncology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.

Sara Watutantrige-Fernando (S)

Hereditary Tumor Unit, Istituto Oncologico Veneto, IOV - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy.

Teresa Zielli (T)

Oncology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.

Elisa Zanardi (E)

Academic Unit of Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Martino Hospital, Genova, Italy.

Roberto Sabbatini (R)

Oncology Unit, Azienda Ospedaliera Universitaria di Modena, Modena, Italy.

Umberto Basso (U)

Oncology Unit 1, Istituto Oncologico Veneto, IOV - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy.

Vittorina Zagonel (V)

Oncology Unit 1, Istituto Oncologico Veneto, IOV - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy.

Giuseppe Procopio (G)

Genito-Urinary (GU) Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Istituto Nazionale dei Tumori, Milano, Italy.

Classifications MeSH