The following is a summary of “Clinical Characters and Influence Factors of Immune Checkpoint Inhibitor-related Thyroid Dysfunction,” published in the November 2023 issue of Endocrinology by Zhang, et al.

For a retrospective study, researchers sought to explore the clinical characteristics and influencing factors of immune thyroid dysfunction (ITD) resulting from immune checkpoint inhibitors (ICIs) in treating malignant tumors.

Conducted at the Second Affiliated Hospital of Nanchang University, this study involved cancer patients treated with ICIs from January 2019 to December 2021. Patients were categorized into an ITD group and a non-ITD group based on the occurrence of thyroid dysfunction. The study described the clinical characteristics, autoantibody levels, and their impact on the prognosis of patients with ICI-related ITD.

Among the 560 cases meeting the criteria, the incidence of ITD was 50.7%, with a median follow-up time of 11.0 months. Baseline TSH levels (OR, 1.935/mcIU/L; 95% CI, 1.613-2.321; P < .001) and combination targeted therapy (OR, 2.101; 95% CI, 1.433-3.079; P < .001) were identified as the most strongly associated factors with ITD occurrence. The median time to ITD in patients receiving ICI medication was 73 (34.5-149) days. Among initially diagnosed hyperthyroid ITD patients, 46 (52.9%) progressed to hypothyroidism. Baseline anti-thyroglobulin antibody abnormalities were strongly associated with ITD occurrence (OR, 67.393; 95% CI, 5.637-805.656; P = .001). Patients not developing ITD showed significantly lower overall survival than those who did (hazard ratio, 0.523; 95% CI, 0.599-0.97; P < .001).

The study concluded that the incidence of ICI-related ITD was high, with a rapidly changing disease course. Regular monitoring of thyroid function in patients undergoing immunotherapy is crucial for early detection of ITD and timely intervention.

Source: academic.oup.com/jcem/article/108/11/2916/7161947