Search Results

You are looking at 1 - 3 of 3 items for

  • Author: Claudia Moneta x
Clear All Modify Search
Carla Colombo Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Search for other papers by Carla Colombo in
Google Scholar
PubMed
Close
,
Daniele Ceruti Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

Search for other papers by Daniele Ceruti in
Google Scholar
PubMed
Close
,
Massimiliano Succi Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

Search for other papers by Massimiliano Succi in
Google Scholar
PubMed
Close
,
Simone De Leo Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy

Search for other papers by Simone De Leo in
Google Scholar
PubMed
Close
,
Matteo Trevisan Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

Search for other papers by Matteo Trevisan in
Google Scholar
PubMed
Close
,
Claudia Moneta Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

Search for other papers by Claudia Moneta in
Google Scholar
PubMed
Close
, and
Laura Fugazzola Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Search for other papers by Laura Fugazzola in
Google Scholar
PubMed
Close

Background

Fatigue is a frequent adverse event during systemic treatments for advanced thyroid cancer, often leading to reduction, interruption, or discontinuation. We were the first group to demonstrate a correlation between fatigue and primary adrenal insufficiency (PAI).

Aim

The objective was to assess the entire adrenal function in patients on systemic treatments.

Methods

ACTH, cortisol and all the hormones produced by the adrenal gland were evaluated monthly in 36 patients (25 on lenvatinib, six on vandetanib, and five on selpercatinib). ACTH stimulation tests were performed in 26 cases.

Results

After a median treatment period of 7 months, we observed an increase in ACTH values in 80–100% of patients and an impaired cortisol response to the ACTH test in 19% of cases. Additionally, dehydroepiandrosterone sulphate, ∆-4-androstenedione and 17-OH progesterone levels were below the median of normal values in the majority of patients regardless of the drug used. Testosterone in females and oestradiol in males were below the median of normal values in the majority of patients on lenvatinib and vandetanib. Finally, aldosterone was below the median of the normal values in most cases, whilst renin levels were normal. Metanephrines and normetanephrines were always within the normal range. Replacement therapy with cortisone acetate improved fatigue in 14/17 (82%) patients with PAI.

Conclusion

Our data confirm that systemic treatments for advanced thyroid cancer can lead to impaired cortisol secretion. A reduction in the other hormones secreted by the adrenal cortex has been first reported and should be considered in the more appropriate management of these fragile patients.

Open access
Carla Colombo Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Search for other papers by Carla Colombo in
Google Scholar
PubMed
Close
,
Daniele Ceruti Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Search for other papers by Daniele Ceruti in
Google Scholar
PubMed
Close
,
Simone De Leo Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, Milan, Italy

Search for other papers by Simone De Leo in
Google Scholar
PubMed
Close
,
Grzegorz Bilo Department of Cardiology, San Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

Search for other papers by Grzegorz Bilo in
Google Scholar
PubMed
Close
,
Matteo Trevisan Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Search for other papers by Matteo Trevisan in
Google Scholar
PubMed
Close
,
Noemi Giancola Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Search for other papers by Noemi Giancola in
Google Scholar
PubMed
Close
,
Claudia Moneta Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Search for other papers by Claudia Moneta in
Google Scholar
PubMed
Close
,
Gianfranco Parati Department of Cardiology, San Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

Search for other papers by Gianfranco Parati in
Google Scholar
PubMed
Close
,
Luca Persani Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

Search for other papers by Luca Persani in
Google Scholar
PubMed
Close
, and
Laura Fugazzola Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Search for other papers by Laura Fugazzola in
Google Scholar
PubMed
Close

Background

Hypertension (HTN) is the most frequent adverse event during treatment with lenvatinib (LEN), but data on its best management are limited.

Aim

The objective of this study was to assess incidence, features and best management of LEN-related HTN in a consecutive single tertiary-care centre cohort.

Methods

Twenty-nine patients were followed up for a mean time of 29.8 months (6–77 months).

Results

After a mean follow-up of 6.8 months, HTN was recorded in 76% of cases, as a de novo occurrence in half of them. HTN significantly correlated with LEN dose and was of grade 1, grade 2 and grade 3 in 5%, 50% and 45% of patients, respectively. The majority (77%) of patients with HTN developed proteinuria. There was no correlation between HTN and proteinuria or clinical features or best morphological response or any other adverse event (AE), with the exception of diarrhoea. Patients with or without pre-existing HTN or any other cardiovascular disease had a similar incidence of HTN during LEN, thus excluding the impact of this potential predisposing factor. After evaluation by a dedicated cardiologist, medical treatment was introduced in 21/22 patients (polytherapy in 20 of them). The most frequently used drugs were calcium channel blockers (CCBs) due to their effect on vasodilation. In case of poor control, CCBs were associated with one or more anti-hypertensive drug.

Conclusion

HTN is a frequent and early AE in patients on LEN treatment. We suggest a diagnostic and therapeutic algorithm to be applied in clinical practice to allow efficient HTN control and improve patient compliance, reducing LEN discontinuation.

Open access
Valentina Cirello Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Search for other papers by Valentina Cirello in
Google Scholar
PubMed
Close
,
Marina Lugaresi Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

Search for other papers by Marina Lugaresi in
Google Scholar
PubMed
Close
,
Claudia Moneta Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

Search for other papers by Claudia Moneta in
Google Scholar
PubMed
Close
,
Patrice Dufour Department of Clinical, Forensic and Environmental Toxicology, University hospital of Liege (CHU Liège), CHU (B35), Liege, Belgium
Center for Interdisciplinary Research on Medicines (C.I.R.M.), University of Liege (ULiège), CHU (B35), Liege, Belgium

Search for other papers by Patrice Dufour in
Google Scholar
PubMed
Close
,
Alessandro Manzo Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

Search for other papers by Alessandro Manzo in
Google Scholar
PubMed
Close
,
Erika Carbone Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy

Search for other papers by Erika Carbone in
Google Scholar
PubMed
Close
,
Carla Colombo Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Search for other papers by Carla Colombo in
Google Scholar
PubMed
Close
,
Laura Fugazzola Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

Search for other papers by Laura Fugazzola in
Google Scholar
PubMed
Close
,
Corinne Charlier Department of Clinical, Forensic and Environmental Toxicology, University hospital of Liege (CHU Liège), CHU (B35), Liege, Belgium
Center for Interdisciplinary Research on Medicines (C.I.R.M.), University of Liege (ULiège), CHU (B35), Liege, Belgium

Search for other papers by Corinne Charlier in
Google Scholar
PubMed
Close
, and
Catherine Pirard Department of Clinical, Forensic and Environmental Toxicology, University hospital of Liege (CHU Liège), CHU (B35), Liege, Belgium
Center for Interdisciplinary Research on Medicines (C.I.R.M.), University of Liege (ULiège), CHU (B35), Liege, Belgium

Search for other papers by Catherine Pirard in
Google Scholar
PubMed
Close

Objective

The aim was to evaluate the possible association between some endocrine disruptive chemicals and thyroid cancer (TC) in an Italian case–control cohort.

Methods

We enrolled 112 TC patients and 112 sex- and age-matched controls without known thyroid diseases. Per- and poly-fluoroalkyl substances (PFAS), poly-chlorinated biphenyls (PCBs), and dichlorodiphenyltrichloroethane (4,4′-DDT and 4,4′-DDE) were measured in the serum by liquid or gas chromatography–mass spectrometry. Unconditional logistic regression, Bayesan kernel machine regression and weighted quantile sum models were used to estimate the association between TC and pollutants’ levels, considered individually or as mixture. BRAF V600E mutation was assessed by standard methods.

Results

The detection of perfluorodecanoic acid (PFDA) was positively correlated to TC (OR = 2.03, 95% CI: 1.10–3.75, P = 0.02), while a negative association was found with perfluorohexanesulfonic acid (PFHxS) levels (OR = 0.63, 95% CI: 0.41–0.98, P = 0.04). Moreover, perfluorononanoic acid (PFNA) was positively associated with the presence of thyroiditis, while PFHxS and perfluorooctane sulfonic acid (PFOS) with higher levels of presurgical thyroid-stimulating hormone (TSH). PFHxS, PFOS, PFNA, and PFDA were correlated with less aggressive TC, while poly-chlorinated biphenyls (PCB-105 and PCB-118) with larger and more aggressive tumors. Statistical models showed a negative association between pollutants’ mixture and TC. BRAF V600E mutations were associated with PCB-153, PCB-138, and PCB-180.

Conclusion

Our study suggests, for the first time in a case–control population, that exposure to some PFAS and PCBs associates with TC and some clinical and molecular features. On the contrary, an inverse correlation was found with both PFHxS and pollutants’ mixture, likely due to a potential reverse causality.

Open access