Incidence of Thyroid Function Test Abnormalities in Patients Receiving Immune-Checkpoint Inhibitors for Cancer Treatment

The Oncologist
Nisha Subhash PatelSandip Pravin Patel

Abstract

With the advent of immune-checkpoint inhibitor (ICI) therapy (anti-CTLA-4, anti-PD-1), immune-related adverse events such as thyroid function test abnormalities (TFTAs) are common, with a reported incidence range of 2%-15% depending upon the ICI used. The aim of this study is to describe the incidence of TFTAs retrospectively in patients who received ICI therapy. A total of 285 patients were reviewed (178 male, 107 female; 16-94 years of age), of whom 218 had no baseline TFTAs, 61 had baseline TFTAs, and 6 had a history of thyroidectomy (excluded). At least one dose of ipilimumab and/or nivolumab or pembrolizumab was administered. Post-ICI therapy TFTAs were classified according to standard definitions of thyroid conditions when possible. A total of 35% (76/218) patients had new-onset TFTAs on ICI therapy. Of note, 70.5% (43/61) had baseline TFTAs that were exacerbated by ICI therapy. The median times to new-onset or exacerbated baseline TFTA were 46 and 33 days, respectively. Of note, 64.5% (20/31) of patients on both ipilimumab and nivolumab had new-onset TFTAs, compared with 31.3% (15/48) on ipilimumab, 31.5% (28/89) on nivolumab, and 26% (13/50) on pembrolizumab. The incidence of TFTAs with ICI therapy was higher than previ...Continue Reading

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Citations

Apr 17, 2020·Diagnostics·Vanina VaniEmanuele Neri
May 17, 2019·Nature Reviews. Clinical Oncology·Filipe MartinsMichel Obeid
Jul 28, 2020·Cancer Immunology, Immunotherapy : CII·Joana Lima FerreiraIsabel Torres
Apr 9, 2020·Thyroid : Official Journal of the American Thyroid Association·Christopher A MuirVenessa H M Tsang
Dec 28, 2019·Bulletin du cancer·Christine Cugnet AnceauEmmanuel Disse
May 1, 2021·Cancers·Mathilde PeiffertJuliette Abeillon-du Payrat
May 25, 2021·Critical Reviews in Oncology/hematology·Carmen CriscitielloGiuseppe Curigliano

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