Durvalumab-induced thyroiditis in a patient with non-small cell lung carcinoma: a case report and review of pathogenic mechanisms
Abstract Background Immune checkpoint inhibitors (ICI) targeting cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed cell death protein 1 and its ligand (PD-1/PD-L1) have become the current standard-of-care for advanced cancers. This novel therapeutic approach comes with its costs in th...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Endocrine Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12902-022-01190-5 |
| _version_ | 1797986833207918592 |
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| author | Jeroen M. K. de Filette Stéphanie André Lynn De Mey Sandrine Aspeslagh Rafik Karmali Bart J Van der Auwera Bert Bravenboer |
| author_facet | Jeroen M. K. de Filette Stéphanie André Lynn De Mey Sandrine Aspeslagh Rafik Karmali Bart J Van der Auwera Bert Bravenboer |
| author_sort | Jeroen M. K. de Filette |
| collection | DOAJ |
| description | Abstract Background Immune checkpoint inhibitors (ICI) targeting cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed cell death protein 1 and its ligand (PD-1/PD-L1) have become the current standard-of-care for advanced cancers. This novel therapeutic approach comes with its costs in the form of immune-related adverse events (irAE), including endocrinopathy. Case presentation A 63-year-old woman was diagnosed with a non-small cell lung carcinoma of the right superior lobe, cT3N2M0. She developed thyrotoxicosis followed by hypothyroidism induced by consolidation immunotherapy with durvalumab (anti-PD-L1). Analysis of the human leukocyte antigen (HLA) region showed HLA-DR4 (susceptible) and DR13 (protective). The possible mechanisms are subsequently discussed in detail. Conclusions The case of a patient with thyroiditis associated with the PD-L1 inhibitor durvalumab is described, highlighting the need for proactive monitoring of thyroid hormone levels. Identifying biomarkers associated with an increased risk of ICI-induced side effects (such as HLA) is of interest for better patient selection, optimal management and improved understanding of the mechanisms involved. |
| first_indexed | 2024-04-11T07:39:12Z |
| format | Article |
| id | doaj.art-1051afc9a877407b9bc182c7a451b341 |
| institution | Directory Open Access Journal |
| issn | 1472-6823 |
| language | English |
| last_indexed | 2024-04-11T07:39:12Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Endocrine Disorders |
| spelling | doaj.art-1051afc9a877407b9bc182c7a451b3412022-12-22T04:36:38ZengBMCBMC Endocrine Disorders1472-68232022-11-012211510.1186/s12902-022-01190-5Durvalumab-induced thyroiditis in a patient with non-small cell lung carcinoma: a case report and review of pathogenic mechanismsJeroen M. K. de Filette0Stéphanie André1Lynn De Mey2Sandrine Aspeslagh3Rafik Karmali4Bart J Van der Auwera5Bert Bravenboer6Department of Endocrinology, Brugmann University Hospital, Université Libre de BruxellesDepartment of Pulmonary Medicine, Saint-Pierre University HospitalDepartment of Nuclear Medicine, UZ BrusselDepartment of Medical Oncology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel)Department of Endocrinology, UZ BrusselDiabetes Research Center, Vrije Universiteit BrusselDepartment of Endocrinology, Brugmann University Hospital, Université Libre de BruxellesAbstract Background Immune checkpoint inhibitors (ICI) targeting cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed cell death protein 1 and its ligand (PD-1/PD-L1) have become the current standard-of-care for advanced cancers. This novel therapeutic approach comes with its costs in the form of immune-related adverse events (irAE), including endocrinopathy. Case presentation A 63-year-old woman was diagnosed with a non-small cell lung carcinoma of the right superior lobe, cT3N2M0. She developed thyrotoxicosis followed by hypothyroidism induced by consolidation immunotherapy with durvalumab (anti-PD-L1). Analysis of the human leukocyte antigen (HLA) region showed HLA-DR4 (susceptible) and DR13 (protective). The possible mechanisms are subsequently discussed in detail. Conclusions The case of a patient with thyroiditis associated with the PD-L1 inhibitor durvalumab is described, highlighting the need for proactive monitoring of thyroid hormone levels. Identifying biomarkers associated with an increased risk of ICI-induced side effects (such as HLA) is of interest for better patient selection, optimal management and improved understanding of the mechanisms involved.https://doi.org/10.1186/s12902-022-01190-5DurvalumabThyroiditisImmune Checkpoint InhibitorsHLACase Report |
| spellingShingle | Jeroen M. K. de Filette Stéphanie André Lynn De Mey Sandrine Aspeslagh Rafik Karmali Bart J Van der Auwera Bert Bravenboer Durvalumab-induced thyroiditis in a patient with non-small cell lung carcinoma: a case report and review of pathogenic mechanisms BMC Endocrine Disorders Durvalumab Thyroiditis Immune Checkpoint Inhibitors HLA Case Report |
| title | Durvalumab-induced thyroiditis in a patient with non-small cell lung carcinoma: a case report and review of pathogenic mechanisms |
| title_full | Durvalumab-induced thyroiditis in a patient with non-small cell lung carcinoma: a case report and review of pathogenic mechanisms |
| title_fullStr | Durvalumab-induced thyroiditis in a patient with non-small cell lung carcinoma: a case report and review of pathogenic mechanisms |
| title_full_unstemmed | Durvalumab-induced thyroiditis in a patient with non-small cell lung carcinoma: a case report and review of pathogenic mechanisms |
| title_short | Durvalumab-induced thyroiditis in a patient with non-small cell lung carcinoma: a case report and review of pathogenic mechanisms |
| title_sort | durvalumab induced thyroiditis in a patient with non small cell lung carcinoma a case report and review of pathogenic mechanisms |
| topic | Durvalumab Thyroiditis Immune Checkpoint Inhibitors HLA Case Report |
| url | https://doi.org/10.1186/s12902-022-01190-5 |
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