Coronary Artery and Peripheral Vascular Disease in a Patient with Poorly Differentiated Thyroid Cancer Treated with the Tyrosine Kinase Inhibitor Lenvatinib

Author:

Sukrithan Vineeth1ORCID,Kim Lisa2ORCID,Sipos Jennifer A.3ORCID,Goyal Ashima1,Zhou Ye1,Addison Daniel2,Shah Manisha1,Konda Bhavana1ORCID,Vallakati Ajay2ORCID

Affiliation:

1. Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA

2. Department of Internal Medicine, Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA

3. Department of Internal Medicine, Division of Endocrinology, The Ohio State University Wexner Medical Center, Columbus, OH, USA

Abstract

A subset of patients with differentiated thyroid carcinoma develop radioiodine refractory (RAIR) incurable disease, which typically has a poor prognosis. The multitargeted tyrosine kinase inhibitor lenvatinib has demonstrated significant improvements in progression-free survival in RAIR thyroid cancers compared to placebos. However, in the phase III SELECT trial of the drug in thyroid cancer, 5.4% of patients on lenvatinib experienced arterial thromboembolic events, with 2.7% experiencing severe grade ≥3 toxicities associated with arterial vascular events. This case study reports a patient with metastatic poorly differentiated follicular thyroid cancer who developed significant obstructive coronary artery disease following initiation of lenvatinib treatment, despite no predisposing cardiovascular risk factors apart from a remote smoking history. The possibility of developing coronary or peripheral artery disease should be considered in patients who are on targeted therapies, such as lenvatinib, even in the absence of traditional cardiovascular risk factors. In addition, baseline cardiac risk assessment and early treatment should be pursued to minimize interruptions to potentially lifesaving cancer therapy.

Publisher

Hindawi Limited

Subject

Endocrinology, Diabetes and Metabolism

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