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
Citation: 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

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

doi: 10.12259/j.issn.2095-610X.S20240111
  • Received Date: 2023-09-22
    Available Online: 2024-01-04
  • Publish Date: 2024-01-25
  •   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.
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  • [1]
    De Miguel M,Calvo E. Clinical challenges of immune checkpoint inhibitors[J]. Cancer Cell,2020,38(3):326-333. doi: 10.1016/j.ccell.2020.07.004
    [2]
    Postow M A,Callahan M K,Wolchok J D. Immune checkpoint blockade in cancer therapy[J]. J Clin Oncol,2015,33(17):1974-1982. doi: 10.1200/JCO.2014.59.4358
    [3]
    Schneider B J,Naidoo J,Santomasso B D,et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: ASCO guideline update[J]. J Clin Oncol,2021,39(36):4073-4126.
    [4]
    侯静文,马晓君. 程序性死亡受体1抑制剂相关甲状腺功能异常的影响因素分析[J]. 肿瘤基础与临床,2021,34(3):257-260. doi: 10.3969/j.issn.1673-5412.2021.03.020
    [5]
    魏芬芬,相丽,宋耕,等. PD-1单抗引起甲状腺功能异常的发生情况及相关因素研究[J]. 临床肿瘤学杂志,2020,25(10):930-934.
    [6]
    Ross D S,Burch H B,Cooper D S,et al. 2016 American thyroid association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis[J]. Thyroid:Official Journal of the American Thyroid Association,2016,26(10):1343-1421. doi: 10.1089/thy.2016.0229
    [7]
    Postow M A,Sidlow R,Hellmann M D. Immune-related adverse events associated with immune checkpoint blockade[J]. The New England Journal of Medicine,2018,378(2):158-168. doi: 10.1056/NEJMra1703481
    [8]
    Barroso-Sousa R,Barry W T,Garrido-Castro A C,et al. Incidence of endocrine dysfunction following the use of different immune checkpoint inhibitor regimens: A systematic review and meta-analysis[J]. JAMA Oncology,2018,4(2):173-182. doi: 10.1001/jamaoncol.2017.3064
    [9]
    Patel N S,Oury A,Daniels G A,et al. Incidence of thyroid function test abnormalities in patients receiving immune-checkpoint inhibitors for cancer treatment[J]. The Oncologist,2018,23(10):1236-1241.
    [10]
    Percik R,Liel Y,Urban D,et al. Thyroid dysfunction and survival in cancer patients treated with immune checkpoint inhibitors: Analyses from a large single tertiary cancer center database[J]. Acta Oncologica (Stockholm,Sweden),2021,60(11):1466-1471. doi: 10.1080/0284186X.2021.1958006
    [11]
    Delivanis D A,Gustafson M P,Bornschlegl S,et al. Pembrolizumab-induced thyroiditis: Comprehensive clinical review and insights into underlying involved mechanisms[J]. The Journal of Clinical Endocrinology and Metabolism,2017,102(8):2770-2780. doi: 10.1210/jc.2017-00448
    [12]
    Ruggeri R M,Spagnolo C C,Alibrandi A,et al. Predictors of thyroid adverse events during cancer immunotherapy: A real-life experience at a single center[J]. Journal of Endocrinological Investigation,2023,46(11):2399-2409. doi: 10.1007/s40618-023-02096-2
    [13]
    Okura N,Asano M,Uchino J,et al. Endocrinopathies associated with immune checkpoint inhibitor cancer treatment: A review[J]. Journal of Clinical Medicine,2020,9(7):2033. doi: 10.3390/jcm9072033
    [14]
    Campredon P,Mouly C,Lusque A,et al. Incidence of thyroid dysfunctions during treatment with nivolumab for non-small cell lung cancer: Retrospective study of 105 patients[J]. Presse Medicale (Paris,France,1983),2019,48(4):e199-e207.
    [15]
    Baek H S,Jeong C,Shin K,et al. Association between the type of thyroid dysfunction induced by immune checkpoint inhibitors and prognosis in cancer patients[J]. BMC Endocrine Disorders,2022,22(1):89. doi: 10.1186/s12902-022-01004-8
    [16]
    Brilli L,Danielli R,Campanile M,et al. Baseline serum TSH levels predict the absence of thyroid dysfunction in cancer patients treated with immunotherapy[J]. Journal of Endocrinological Investigation,2021,44(8):1719-1726. doi: 10.1007/s40618-020-01480-6
    [17]
    Pollack R M,Kagan M,Lotem M,et al. Baseline TSH level is associated with risk of anti-PD-1-induced thryoid dysfunction[J]. Endocrine Practice:Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists,2019,25(8):824-829. doi: 10.4158/EP-2018-0472
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