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Immune checkpoint inhibitor induced thyroid dysfunction is a frequent event post-treatment in NSCLC
- Source :
- Lung Cancer, Lung Cancer, 2021, 161, pp.34-41. ⟨10.1016/j.lungcan.2021.08.009⟩
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Introduction Thyroid dysfunction is the most frequent endocrine immune related adverse event (irAE) in non-small cell lung cancer (NSCLC), typically arising 3–6 months into immune checkpoint inhibitor (ICI) therapy, but arising after ICI cessation, in some cases. Due to limited post-treatment adverse event reporting requirements on ICI trials, the incidence of ICI-induced thyroid dysfunction arising after therapy is unclear. We investigated ICI-induced thyroid dysfunction in a cohort of 294 NSCLC patients, with a specific focus on the post-treatment setting. Methods Retrospective analysis of ICI-induced thyroid dysfunction (clinically acted upon or laboratory only) was performed in 294 UCLA NSCLC patients treated 2012–2018. Clinically acted upon thyroid dysfunction was defined as thyroid diagnosis documentation and/or thyroid medication administration. Laboratory only dysfunction was defined as abnormal thyroid labs in the absence of clinical action. Timing of thyroid dysfunction relative to ICI treatment and thyroid monitoring patterns were also assessed. Results 82% (241/294) of ICI treated NSCLC patients had thyroid labs during treatment. Of these 241 patients, 13% (31/241) had clinically acted upon thyroid dysfunction prior to, 8% (18/241) during, and 4% (9/241) after ICI. Most patients, 66% (159/241), did not have thyroid labs after ICI, but in the 53 patients with labs and no prior clinical dysfunction, 17% (9/53) developed clinical dysfunction after ICI. In these 9 patients, median time from ICI initiation to dysfunction was 253 days. Two patients with post-treatment laboratory only dysfunction were observed. Conclusions ICI-induced thyroid dysfunction arising post-treatment appears more common than previously appreciated, warranting additional evaluation.
- Subjects :
- Oncology
Cancer Research
Lung Neoplasms
Anti-PD-(L)1 therapy
endocrine system diseases
[SDV]Life Sciences [q-bio]
Thyroid Gland
non-small cell lung cancer (NSCLC)
Immune checkpoint inhibitor
Non-small cell lung cancer
Carcinoma, Non-Small-Cell Lung
Non-Small-Cell Lung
Lung
Immune Checkpoint Inhibitors
ComputingMilieux_MISCELLANEOUS
Cancer
Incidence (epidemiology)
Lung Cancer
Thyroid
Thyroid dysfunction
[SDV] Life Sciences [q-bio]
medicine.anatomical_structure
6.1 Pharmaceuticals
Cohort
hormones, hormone substitutes, and hormone antagonists
Pulmonary and Respiratory Medicine
endocrine system
medicine.medical_specialty
Clinical Sciences
Oncology and Carcinogenesis
Article
Immune system
Immune related adverse events
Clinical Research
Internal medicine
medicine
Humans
Endocrine system
Oncology & Carcinogenesis
Adverse effect
Retrospective Studies
business.industry
Carcinoma
Evaluation of treatments and therapeutic interventions
Retrospective cohort study
medicine.disease
Good Health and Well Being
business
Subjects
Details
- ISSN :
- 01695002
- Volume :
- 161
- Database :
- OpenAIRE
- Journal :
- Lung Cancer
- Accession number :
- edsair.doi.dedup.....eda1b68f81e42d1fcf2d78316dc5c9ea