Impairment in the hypothalamic–pituitary–gonadal axis in males with medullary thyroid carcinoma treated with selpercatinib
Authors' conclusion
ED shows high prevalence and early onset in males with MTC treated with selpercatinib. Impairment in the HPG axis and semen analysis can reflect damage to Sertoli and Leydig cells, leading to hypogonadism.
Study context
- Population
- Male patients with advanced medullary thyroid carcinoma (MTC) treated with selpercatinib
- Participants
- 19 vs 7
- Exposure
- Hypothalamic-pituitary-gonadal (HPG) axis before vs after selpercatinib initiation
- T-Groupn = 19
- Ex-Groupn = 7
- Outcome
- HPG axis variation (FSH) in T-Group
- Follow-up
- First year of treatment
Main finding
As reported in the abstract
FSH change in T-Group, p = 0.03
+61.9%
Observational data: associations, not effects.
Further findings
HPG axis changes, first year · 12 months
- FSH increase (T-Group)
- +61.9%, p = 0.03
HPG axis changes, beyond 24 months
- FSH increase (Ex-Group)
- +60.6%
- LH increase (Ex-Group)
- +20.5%, p < 0.01
- Sex Hormone Binding Globulin (SHBG) increase (Ex-Group)
- +27.7%, p = 0.04
- Total Testosterone (TT) decrease (Ex-Group)
- −20%, p = 0.01
- Free Testosterone (FreeT) decrease (Ex-Group)
- −12.5%, p < 0.01
Semen analysis
- Semen analysis performed
- 6 (31.6%)
- Azoospermia
- 5
- Severe oligospermia
- 1
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Impairment in the hypothalamic–pituitary–gonadal axis in males with medullary thyroid carcinoma treated with selpercatinib. J Clin Endocrinol Metab. Published 23 July 2026. doi:10.
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