Clinical Studies on Thyroid Dysfunction Caused by Immune Checkpoint Inhibitors in Tumor Patients

Meng LI; Ben NIU; Jin HU; Yanlin MA

doi:10.12259/j.issn.2095-610X.S20240111

Volume 45 Issue 1

Jan. 2024

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Meng LI, Ben NIU, Jin HU, Yanlin MA. Clinical Studies on Thyroid Dysfunction Caused by Immune Checkpoint Inhibitors in Tumor Patients[J]. Journal of Kunming Medical University, 2024, 45(1): 67-72. doi: 10.12259/j.issn.2095-610X.S20240111

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Meng LI, Ben NIU, Jin HU, Yanlin MA. Clinical Studies on Thyroid Dysfunction Caused by Immune Checkpoint Inhibitors in Tumor Patients[J]. Journal of Kunming Medical University, 2024, 45(1): 67-72. doi: 10.12259/j.issn.2095-610X.S20240111

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Clinical Studies on Thyroid Dysfunction Caused by Immune Checkpoint Inhibitors in Tumor Patients

doi: 10.12259/j.issn.2095-610X.S20240111

Meng LI¹,
Ben NIU^{1
,
,},
Jin HU¹,
Yanlin MA²

1.
Dept. of Geriatrics
2.
Dept. of Pharmacy，The Affiliated Hospital of Kunming University of Science and Technology; The 1st People’s Hospital of Yunnan Province，Kunming Yunnan 650034，China

Received Date: 2023-09-22
Available Online: 2024-01-04
Publish Date: 2024-01-25

Abstract

Abstract

Objective To investigate the clinical characteristics and risk factors of thyroid dysfunction（TD） in malignant tumor patients treated with immune checkpoint inhibitors（ICIs）. Methods A total of 157 cancer patients who were hospitalized and received ICIs treatment in the First People's Hospital of Yunnan Province from January 2019 to June 2022 were collected and divided into the normal thyroid function group and abnormal thyroid function group based on whether TD had occurred. Fifty-eight patients with the normal thyroid function and 58 patients with the abnormal thyroid function were selected, and 58 healthy adults who underwent the physical examination in our hospital were randomly selected as the control group. The baseline data on the gender, age, tumor and ICIs type, history of surgery before medication, history of radiotherapy and chemotherapy, and the related indicators of liver and kidney function, blood lipids, thyroid hormone levels and so on were collected. The relevant indicators of the three groups were statistically analyzed, and the normal thyroid function group and abnormal thyroid function group were compared to evaluate the clinical characteristics and related risk factors of TD caused by ICIs. Results 1. Among 157 patients treated with ICIs, 58 cases（36.9%） had thyroid dysfunction, including 39 cases of hypothyroidism（including subclinical hypothyroidism）, 9 cases of hyperthyroidism（including subclinical hyperthyroidism）, and 10 cases of pure related antibody abnormality. 2. The analysis of the data of the normal thyroid function group, the abnormal thyroid function group and the control group showed that the age, thyroid stimulating hormone（TSH）, and thyroid function of the three groups were significantly different. TSH） baseline level, free triiodothyronine（FT3） baseline level and aspartate transaminase（AST） baseline level were statistically different（P < 0.05）. There were significant differences in TSH baseline and radiotherapy history between the normal thyroid function group and the abnormal thyroid function group（P < 0.05）; Multivariate analysis showed that the radiotherapy history（OR=7.291, 95%CI= 1.579-33.663, P < .05）, baseline TSH level（OR=3.917, 95%CI= 1.697-9.038, P < 0.05） were the independent risk factors for thyroid dysfunction in cancer patients after ICIs treatment. Conclusion Hypothyroidism is the most common type of TD caused by ICIs in cancer patients. The baseline TSH level and the history of radiotherapy are the independent risk factors for thyroid dysfunction.
- Immunocheckpoint inhibitors,
- Thyroid dysfunction,
- Immune-related adverse events,
- Malignant tumor,
- Risk factor

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