ArticleThe Journal of clinical endocrinology and metabolism2019
Primary Adrenal Insufficiency During Lenvatinib or Vandetanib and Improvement of Fatigue After Cortisone Acetate Therapy.
Article in The Journal of clinical endocrinology and metabolism, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Pooled it
- Carnitine insufficiency is associated with fatigue during lenvatinib treatment in patients with hepatocellular carcinoma.PloS one · 2020Trial
- The Real-World Endocrine Toxicity Profile of ICIs, VEGFR-TKIs, and Their Combination: Analysis of the FDA Adverse Event Reporting System (FAERS) Database.Oncology research · 2026Article
- Effects of cabozantinib on plasma adrenocorticotropic hormone and serum cortisol levels in patients with metastatic renal cell carcinoma: a retrospective study.BMC endocrine disorders · 2025Article
- Mild Primary Adrenal Insufficiency During Treatment With Lenvatinib and Pembrolizumab: A Report of 3 Patients.JCEM case reports · 2025Article
- Effects of Lenvatinib treatment for advanced differentiated thyroid cancer on cortisol deficiency.Frontiers in endocrinology · 2025Article
- Impact of systemic treatments for advanced thyroid cancer on the adrenal cortex.European thyroid journal · 2024Article
- Adrenal insufficiency in thyroid cancer patients treated with tyrosine kinase inhibitors and detected by ACTH stimulation test.Journal of endocrinological investigation · 2023Article
- Review
- Interplay between stress and cancer-A focus on inflammation.Frontiers in physiology · 2023Review
- Article
- The Changing Face of Drug-induced Adrenal Insufficiency in the Food and Drug Administration Adverse Event Reporting System.The Journal of clinical endocrinology and metabolism · 2022Article
- Targeted Therapy for Adrenocortical Carcinoma: A Genomic-Based Search for Available and Emerging Options.Cancers · 2022Article
- Review
- Management of Progressive Radioiodine-Refractory Thyroid Carcinoma: Current Perspective.Cancer management and research · 2022Review
- Cortisol Deficiency in Lenvatinib Treatment of Thyroid Cancer: An Underestimated Common Adverse Event.Thyroid : official journal of the American Thyroid Association · 2022Article
- Daily Management of Patients on Multikinase Inhibitors' Treatment.Frontiers in oncology · 2022Review
- Target Therapy in Thyroid Cancer: Current Challenge in Clinical Use of Tyrosine Kinase Inhibitors and Management of Side Effects.Frontiers in endocrinology · 2022Review
- Late toxicities burden in patients with radioiodine-refractory differentiated thyroid cancer treated with lenvatinib.Endocrine · 2021Article
- Lenvatinib as first-line treatment for advanced thyroid cancer: long progression-free survival.Endocrine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Context: Two tyrosine kinase inhibitors (TKIs), lenvatinib and vandetanib, are often used to treat advanced radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) and medullary thyroid cancer (MTC), respectively. Fatigue is a common adverse event during treatment with these and other TKIs and a common cause of drug discontinuation or dosage reduction. Cases Description: We evaluated the basal and stimulated adrenal function in 12 patients with advanced RAI-R DTC and MTC treated with lenvatinib or vandetanib, respectively. Ten patients complaining of fatigue showed a progressive ACTH increase with normal cortisol levels. Moreover, six of 10 patients had a blunted cortisol response after ACTH stimulation, thus confirming the diagnosis of primary adrenal insufficiency (PAI). The causal relationship between TKIs and PAI onset was also demonstrated by the repeated testing of adrenal function before and during treatment. Patients with PAI received cortisone acetate replacement therapy, with a substantial and prompt improvement in the degree of fatigue, as assessed by the Common Terminology Criteria for Adverse Events version 4.03, thus supporting the major impact of impaired adrenal function in the genesis of this adverse event. Conclusions: We show that the occurrence of PAI may be a common cause of fatigue during lenvatinib and vandetanib treatment, and we therefore recommend testing adrenal function for a prompt start of replacement therapy to avoid treatment discontinuation, dosage reduction, and potentially severe PAI complications.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.