Refining Personalized Diagnosis, Treatment and Exploitation of Hypothyroidism Related to Solid Nonthyroid Cancer

Abstract

Hypothyroidism in the setting of cancer is a puzzling entity due to the dual role of the thyroid hormones (TH) in cancer – promoting versus inhibitory – and the complexity of the hypothyroidism itself. The present review provides a comprehensive overview of the personalized approach to hypothyroidism in patients with solid nonthyroid cancer, focusing on current challenges, unmet needs and future perspectives. Major electronic databases were searched from January 2011 until March 2022. The milestones of the refinement of such a personalized approach are prompt diagnosis, proper TH replacement and development of interventions and/or pharmaceutical agents to exploit hypothyroidism or, on the contrary, TH replacement as an anticancer strategy. Further elucidation of the dual role of TH in cancer – especially of the interference of TH signaling with the hallmarks of cancer – is anticipated to inform decision-making and optimize patient selection.

Keywords::

• drug-induced hypothyroidism
• genomic actions
• hypothyroidism
• levothyroxine
• liothyronine
• nongenomic actions
• personalized medicine
• solid nonthyroid cancer
• thyroid hormone receptors
• thyroid hormones

Author contributions

MV Deligiorgi conceived the idea, reviewed the literature, drafted the article, revised the manuscript critically for important intellectual content and approved the final version to be published; DT Trafalis conceived the idea, revised the manuscript critically for important intellectual content and approved the final version to be published.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.