Immune checkpoint inhibitor induced thyroid dysfunction is a frequent event post-treatment in NSCLC

Zhou, Nanruoyi; Velez, Maria A.; Bachrach, Benjamin; Gukasyan, Jaklin; Fares, Charlene M.; Cummings, Amy L.; Lind-Lebuffe, Jackson P; Akingbemi, W.; Li, Debory Y.; Brodrick, Paige; Yessuf, Nawal M; Rettinger, Sarah; Grogan, Tristan; Rochigneux, Philippe; Goldman, Jonathan W.; Garon, Edward B.; Lisberg, Aaron

doi:10.1016/j.lungcan.2021.08.009

Cited by 10 publications

(12 citation statements)

References 36 publications

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“…The significant risk factors identified in our study, such as sex, comorbidity burden, and first‐line ICI, were consistent with what previous research have examining in general NSCLC population. 17 , 38 , 39 , 40 , 41 , 42 Meanwhile, we offer evidence in areas where there is controversy in the literature, including whether autoimmune disorders (AID), radiation therapy, and chemotherapy all contribute to irAEs development. A history of AID was previously reported to be associated with an increased flare‐up of AID or an increased risk for irAEs.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors of immune‐related adverse events induced by immune checkpoint inhibitors among older adults with non‐small cell lung cancer

Rong,

Bentley,

Bhattacharya

et al. 2024

Cancer Medicine

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BackgroundImmune checkpoint inhibitor (ICI) treatment has been linked to a variety of immune‐related adverse events (irAEs), which can affect any organ system. The incidence and risk factors of irAEs have not been adequately evaluated among older adults with NSCLC.MethodsA cohort study was conducted using 1999–2019 SEER‐Medicare data among beneficiaries aged ≥65 years with a diagnosis of NSCLC who received nivolumab, pembrolizumab, or atezolizumab. Incident irAEs were identified post‐ICI initiation. Demographic, cancer‐related characteristics, and clinical history risk factors of irAEs were evaluated with competing events considered.ResultsA total of 8175 older NSCLC patients were included (with 46.8% experiencing irAEs). Pneumonitis (16.5%), hypothyroidism (10.5%), arrhythmia (11.18%), and acute kidney injury (AKI) (5.8%) were the most common irAEs. The median time to first irAE was 82 days (IQR: 29–182 days). The earliest onset of irAE occurrence was for hematologic irAEs, while the latest were gastrointestinal, dermatologic, and musculoskeletal irAEs. Fine–Gray regression modeling revealed significantly greater hazards of irAE occurrence in patients who received pembrolizumab at index, did not have CNS metastases, had a history of autoimmune disorder, and had chemotherapy in combination with ICI. Race, socioeconomic status, previous radiation therapy, and comorbidity burden were found to be associated with the occurrence of certain type of irAEs.ConclusionA significant proportion of older patients with NSCLC develop an irAE after receiving ICI treatment. Factors related to cancer and treatment as well as demographics contribute to the increased risk of irAEs. Close monitoring and prediction of irAE among older patients receiving ICI is warranted.

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Section: Discussionmentioning

confidence: 99%

Incidence and risk factors of immune‐related adverse events induced by immune checkpoint inhibitors among older adults with non‐small cell lung cancer

Rong,

Bentley,

Bhattacharya

et al. 2024

Cancer Medicine

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“…Subclinical thyrotoxicosis (n=234) was the most common thyroid irAE, followed by overt thyrotoxicosis (n=154), subclinical hypothyroidism (n=61), and overt hypothyroidism (n=39) ( 89 ). Thyroid dysfunction is the most common endocrine irAE in non-small cell lung cancer (NSCLC) ( 90 ). Primary hypothyroidism occurs in 6%–9% of patients treated with anti-PD-1 and/or anti-PD-L1, 4%–9% of patients treated with anti-CTLA-4, and approximately 16% of patients treated with anti-PD-1 (L)-1 and anti-CTLA-4 ( 91 ).…”

Section: Common Iraesmentioning

confidence: 99%

Immune-related adverse events of immune checkpoint inhibitors: a review

Yin

Han

et al. 2023

Front. Immunol.

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Since the first Immune Checkpoint Inhibitor was developed, tumor immunotherapy has entered a new era, and the response rate and survival rate of many cancers have also been improved. Despite the success of immune checkpoint inhibitors, resistance limits the number of patients who can achieve a lasting response, and immune-related adverse events complicate treatment. The mechanism of immune-related adverse events (irAEs) is unclear. We summarize and discuss the mechanisms of action of immune checkpoint inhibitors, the different types of immune-related adverse events and their possible mechanisms, and describe possible strategies and targets for prevention and therapeutic interventions to mitigate them.

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“…In the US NHANES III study, the prevalence of hypothyroidism was higher than hyperthyroidism, with values of 4.6% and 1.3% respectively [34]. Literature reported a higher percentage of thyroid dysfunction in older age and in the the female sex compared to the male sex [35]. Symptoms of thyroid pathology may be vague or absent or confused with side effects of medication and even of oncological therapy [35].…”

Section: Hypothyroidism and Hyperthyroidism Vs Breast Cancermentioning

confidence: 99%

“…Literature reported a higher percentage of thyroid dysfunction in older age and in the the female sex compared to the male sex [35]. Symptoms of thyroid pathology may be vague or absent or confused with side effects of medication and even of oncological therapy [35]. Many experimental studies suggest a link between hyperthyroidism/hypothyroidism and BC.…”

Section: Hypothyroidism and Hyperthyroidism Vs Breast Cancermentioning

confidence: 99%

The relationship between thyroid and cancer (focus on breast cancer)

Costa,

Greiger

2023

Open J Clin Med Case Rep

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The function of the thyroid gland is very important for metabolic processes including basal metabolic rate, nervous reflexes, temperature regulation, cardiac contractility, intestinal transit and growth and maturation processes of tissues and organs [1]. Therefore, the thyroid affects the function of virtually all organs and systems. Thyroid hormones (THs) called tetraiodothyronine (thyroxine or T4) and triiodothyronine (T3) and a thyroid-stimulating hormone or thyrotropin (THS), play a role in growth, development and metabolism. In adults, diseases commonly associated with the thyroid are caused by excess or lack of THs (hyper or hypothyroidism respectively). However, thyroid hormones and their receptors may play a role in the development and progression of other diseases, namely in the promotion and suppression of tumors [1].

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Immune checkpoint inhibitor induced thyroid dysfunction is a frequent event post-treatment in NSCLC

Cited by 10 publications

References 36 publications

Incidence and risk factors of immune‐related adverse events induced by immune checkpoint inhibitors among older adults with non‐small cell lung cancer

Incidence and risk factors of immune‐related adverse events induced by immune checkpoint inhibitors among older adults with non‐small cell lung cancer

Immune-related adverse events of immune checkpoint inhibitors: a review

The relationship between thyroid and cancer (focus on breast cancer)

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