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Thyroid dysfunctions induced by molecular cancer therapies: a synopsis for nuclear medicine thyroidologists

There is increasing evidence and awareness of the impact of targeted cancer therapies, such as tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICPIs) on thyroid function. Tyrosine kinase inhibitors and ICPIs have found applications in different types of cancer as summarized in Table 1. Therefore, a large number of cancer patients are at risk to develop various forms of thyroid dysfunction. In turn, thyroid dysfunctions may negatively impact the course of underlining cancer disease and the quality of life of cancer patients. Nuclear medicine physicians are involved in diagnosis, staging, monitoring (molecular imaging), and therapy (theragnostics) of cancer patients and, especially in Europe, they are also involved in the clinical care of thyroid patients (i.e., nuclear medicine thyroidology). Then, being aware of the multiple and complex interactions between TKIs and ICPIs and thyroid functioning is the key for (1) appropriate diagnosis and management of therapy-induced thyroid dysfunctions and (2) accurate interpretation of thyroid findings on molecular imaging (i.e., [18F]FDG) during targeted therapy.

tyrosine kinase inhibitors ; immune checkpoint inhibitors ; thyroid dysfunction

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