Metabolic and Endocrine Toxicities of Mitotane: A Systematic Review

Despite the pivotal role of mitotane in adrenocortical carcinoma (ACC) management, data on the endocrine toxicities of this treatment are lacking. The aim of this systematic review is to collect the available evidence on the side effects of mitotane on the endocrine and metabolic systems in both children and adults affected by adrenal carcinoma. Sixteen articles on 493 patients were included. Among the adrenal insufficiency, which is an expected side effect of mitotane, 24.5% of patients increased glucocorticoid replacement therapy. Mineralocorticoid insufficiency usually occurred late in treatment in 36.8% of patients. Thyroid dysfunction is characterized by a decrease in FT4, which occurs within 3–6 months of treatment in 45.4% of patients, while TSH seems to not be a reliable marker. Dyslipidemia is characterized by an increase in both LDL-c and HDL-c (54.2%). Few studies have found evidence of hypertriglyceridemia. In males, gynecomastia and hypogonadism can occur after 3–6 months of treatment (38.4% and 35.6%, respectively), while in pre-menopausal women, mitotane can cause ovarian cysts and, less frequently, menstrual disorders. Most of these side effects appear to be reversible after mitotane discontinuation. We finally suggest an algorithm that could guide metabolic and endocrine safety assessments in patients treated with mitotane for ACC.

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Role of thyroid dysfunction in patients with menstrual disorders

Endocrine Abstracts ◽

10.1530/endoabs.56.ep184 ◽

2018 ◽

Author(s):

Khurshida Nasirova ◽

Aziza Amilova

Keyword(s):

Thyroid Dysfunction ◽

Menstrual Disorders

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Zinc as a complementary treatment for cancer patients: a systematic review

Clinical and Experimental Medicine ◽

10.1007/s10238-020-00677-6 ◽

2021 ◽

Author(s):

C. Hoppe ◽

S. Kutschan ◽

J. Dörfler ◽

J. Büntzel ◽

...

Keyword(s):

Systematic Review ◽

Side Effects ◽

Cancer Treatment ◽

Cancer Patients ◽

Survival Data ◽

Positive Impact ◽

Oral Intake ◽

Quality Reporting ◽

Evidenced Based

AbstractZinc is a trace element that plays an important role in the immune system and cell growth. The role of zinc in cancer treatment has been discussed for some time, however without reaching an evidenced-based consensus. Therefore, we aim to critically examine and review existing evidence on the role of zinc during cancer treatment. In January 2019, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychINFO, CINAHL and PubMed) to find studies concerning the use, effectiveness and potential harm of zinc therapy on cancer patients. Out of initial 5244 search results, 19 publications concerning 23 studies with 1230 patients were included in this systematic review. The patients treated with zinc were mainly diagnosed with head and neck cancer and underwent chemo-, radio- or concurrent radio-chemotherapy. Interventions included the intake of different amounts of zinc supplements and oral zinc rinses. Outcomes (primary endpoints) investigated were mucositis, xerostomia, dysgeusia, pain, weight, dermatitis and oral intake of nutrients. Secondary endpoints were survival data, quality of life assessments and aspects of fatigue, immune responses and toxicities of zinc. The studies were of moderate quality reporting heterogeneous results. Studies have shown a positive impact on the mucositis after radiotherapy. No protection was seen against mucositis after chemotherapy. There was a trend to reduced loss of taste, less dry mouth and oral pain after zinc substitution. No impact was seen on weight, QoL measurements, fatigue, and survival. The risk of side effects from zinc appears to be relatively small. Zinc could be useful in the prevention of oral toxicities during irradiation. It does not help in chemotherapy-induced side effects.

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The role of dietary supplements, including biotics, glutamine, polyunsaturated fatty acids and polyphenols, in reducing gastrointestinal side effects in patients undergoing pelvic radiotherapy: A systematic review and meta-analysis

Clinical and Translational Radiation Oncology ◽

10.1016/j.ctro.2021.04.006 ◽

2021 ◽

Author(s):

Benjamin Bartsch ◽

Chee Kin Then ◽

Elinor Harriss ◽

Christiana Kartsonaki ◽

Anne E. Kiltie

Keyword(s):

Systematic Review ◽

Fatty Acids ◽

Side Effects ◽

Polyunsaturated Fatty Acids ◽

Dietary Supplements ◽

Meta Analysis ◽

Pelvic Radiotherapy ◽

Gastrointestinal Side Effects

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Role of Thyroid Dysfunction in Patients with Menstrual Disorders in Tertiary Care Center of Walled City of Delhi

The Journal of Obstetrics and Gynecology of India ◽

10.1007/s13224-014-0650-0 ◽

2015 ◽

Vol 66 (2) ◽

pp. 115-119 ◽

Cited By ~ 5

Author(s):

Nangia Sangita Ajmani ◽

Vinita Sarbhai ◽

Namrta Yadav ◽

Mohini Paul ◽

Ayesha Ahmad ◽

...

Keyword(s):

Thyroid Dysfunction ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Menstrual Disorders

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Controlling TIME: How MNK Kinases Function to Shape Tumor Immunity

Cancers ◽

10.3390/cancers12082096 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2096

Author(s):

Thao N.D. Pham ◽

Christina Spaulding ◽

Hidayatullah G. Munshi

Keyword(s):

Systematic Review ◽

Immune System ◽

Side Effects ◽

Immune Cells ◽

Cancer Development ◽

Interacting Protein ◽

Immune Systems ◽

Adaptive Immune ◽

Adaptive Immune Systems

A number of studies have clearly established the oncogenic role for MAPK-interacting protein kinases (MNK) in human malignancies. Modulation of MNK activity affects translation of mRNAs involved in cancer development, progression, and resistance to therapies. As a result, there are ongoing efforts to develop and evaluate MNK inhibitors for cancer treatment. However, it is important to recognize that MNK activity also plays an important role in regulating the innate and adaptive immune systems. A better understanding of the role of MNK kinases and MNK-mediated signals in regulating the immune system could help mitigate undesired side effects while maximizing therapeutic efficacy of MNK inhibitors. Here, we provide a systematic review on the function of MNK kinases and their substrates in immune cells.

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Role of amiodarone in the management of atrial arrhythmias in adult Fontan patients

Heart ◽

10.1136/heartjnl-2020-317378 ◽

2020 ◽

pp. heartjnl-2020-317378

Author(s):

Satoshi Kawada ◽

Praloy Chakraborty ◽

Lucy Roche ◽

Erwin N Oechslin ◽

Candice Silversides ◽

...

Keyword(s):

Side Effects ◽

Thyroid Dysfunction ◽

Common Side Effect ◽

Cardiac Side Effects ◽

Increased Risk ◽

Term Administration ◽

Fontan Patients

BackgroundPatients with Fontan circulation are known to be at high risk for developing atrial tachyarrhythmias (AAs). Our objective was to examine the efficacy and safety of amiodarone in the management of ATs in adult Fontan patients.MethodsPrimary outcomes of this single-centre, retrospective study included freedom from AAs and incidence of adverse effects of amiodarone on Fontan patients. Heart failure (HF) events and composite outcomes of death from any cause, Fontan revision and heart transplantation were evaluated as secondary outcomes. Predictors of HF and discontinuing amiodarone were also evaluated.ResultsA total of 61 patients (mean age 31.6±11.3 years, 40.9% female), who were treated with amiodarone in between 1995 and 2018, were included. AAs free survival at 1, 3 and 5 years were 76.2%, 56.9% and 30.6%, respectively. During a median follow-up of 50.5 months, 34 (55.7%) patients developed side effects, and 20 (32.8%) patients discontinued amiodarone due to side effects. Thyroid dysfunction was the most common side effect (n=26, 76.5%), amiodarone-induced thyrotoxicosis (AIT) (n=16, 27.1%) being most common thyroid dysfunction. Young age (age <28.5 years) was associated with discontinuing amiodarone (HR 5.50, 95% CI 1.19 to 25.4, p=0.029). AIT significantly increased risk of HF (HR 4.82, 95% CI 1.71 to 13.6, p=0.003).ConclusionsShort-term efficacy of amiodarone in Fontan physiology is acceptable. However, long-term administration is associated with a reduction of efficacy and a significant prevalence of non-cardiac side effects. AIT is associated with exacerbation of HF. The judicious use of amiodarone administration should be considered in this population.

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