Immune checkpoint inhibitor-induced hypothyroidism predicts treatment response in Japanese subjects
BackgroundImmune checkpoint inhibitors (ICIs) cause a variety of immune-related adverse events (irAEs). Among them, thyroid dysfunction is most frequently observed. Patients with irAEs have higher survival rates than those without irAEs, but there is no certainty as to whether the degree of thyroid...
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1221723/full |
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| author | Yuichiro Iwamoto Tomohiko Kimura Kazunori Dan Mana Ohnishi Haruka Takenouchi Hideyuki Iwamoto Junpei Sanada Yoshiro Fushimi Yukino Katakura Masashi Shimoda Shuhei Nakanishi Tomoatsu Mune Kohei Kaku Hideaki Kaneto |
| author_facet | Yuichiro Iwamoto Tomohiko Kimura Kazunori Dan Mana Ohnishi Haruka Takenouchi Hideyuki Iwamoto Junpei Sanada Yoshiro Fushimi Yukino Katakura Masashi Shimoda Shuhei Nakanishi Tomoatsu Mune Kohei Kaku Hideaki Kaneto |
| author_sort | Yuichiro Iwamoto |
| collection | DOAJ |
| description | BackgroundImmune checkpoint inhibitors (ICIs) cause a variety of immune-related adverse events (irAEs). Among them, thyroid dysfunction is most frequently observed. Patients with irAEs have higher survival rates than those without irAEs, but there is no certainty as to whether the degree of thyroid dysfunction is associated with treatment response or survival with ICIs.MethodThis is a single-center, retrospective, observational study. The study included 466 patients who received ICI at Kawasaki Medical School Hospital from September 1, 2014, to May 31, 2022 and evaluated the degree of abnormal thyroid function and survival and remission rates after treatment with ICIs. Primary hypothyroidism of less than 10 μIU/mL TSH was classified as grade 1, and primary hypothyroidism requiring more than 10 μIU/mL TSH or levothyroxine as grade 2-4.ResultThe mean age of the study participants was 68.2 ± 10.3 years, and the percentage of male participants was 72.6%. The frequency of ICI-induced thyroid dysfunction in the study participants was 28.2%. TSH levels were significantly higher in Grade 1 and Grades 2-4 when treated with ICI compared to NTF (p<0.0001). The survival rate at 1 year after ICI administration was significantly higher with 64.9% for grade 1 and 88.9% for grades 2-4 compared to 52.1% for NTF (p<0.0001). Cancer stage at the time of ICI administration did not differ among the groups (p=0.68). Nevertheless, the remission rate assessed by RECIST criteria was significantly higher in grades 2-4 compared to NTF (p<0.0001).ConclusionICI-induced thyroid dysfunction was significantly correlated with survival, mean observation time, and treatment remission rate. It is important to monitor thyroid hormone levels regularly in patients receiving ICIs. |
| first_indexed | 2024-03-12T20:56:09Z |
| format | Article |
| id | doaj.art-77c1b86b57bc4038bab61931ccf7d031 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-12T20:56:09Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-77c1b86b57bc4038bab61931ccf7d0312023-07-31T16:01:17ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-07-011410.3389/fendo.2023.12217231221723Immune checkpoint inhibitor-induced hypothyroidism predicts treatment response in Japanese subjectsYuichiro IwamotoTomohiko KimuraKazunori DanMana OhnishiHaruka TakenouchiHideyuki IwamotoJunpei SanadaYoshiro FushimiYukino KatakuraMasashi ShimodaShuhei NakanishiTomoatsu MuneKohei KakuHideaki KanetoBackgroundImmune checkpoint inhibitors (ICIs) cause a variety of immune-related adverse events (irAEs). Among them, thyroid dysfunction is most frequently observed. Patients with irAEs have higher survival rates than those without irAEs, but there is no certainty as to whether the degree of thyroid dysfunction is associated with treatment response or survival with ICIs.MethodThis is a single-center, retrospective, observational study. The study included 466 patients who received ICI at Kawasaki Medical School Hospital from September 1, 2014, to May 31, 2022 and evaluated the degree of abnormal thyroid function and survival and remission rates after treatment with ICIs. Primary hypothyroidism of less than 10 μIU/mL TSH was classified as grade 1, and primary hypothyroidism requiring more than 10 μIU/mL TSH or levothyroxine as grade 2-4.ResultThe mean age of the study participants was 68.2 ± 10.3 years, and the percentage of male participants was 72.6%. The frequency of ICI-induced thyroid dysfunction in the study participants was 28.2%. TSH levels were significantly higher in Grade 1 and Grades 2-4 when treated with ICI compared to NTF (p<0.0001). The survival rate at 1 year after ICI administration was significantly higher with 64.9% for grade 1 and 88.9% for grades 2-4 compared to 52.1% for NTF (p<0.0001). Cancer stage at the time of ICI administration did not differ among the groups (p=0.68). Nevertheless, the remission rate assessed by RECIST criteria was significantly higher in grades 2-4 compared to NTF (p<0.0001).ConclusionICI-induced thyroid dysfunction was significantly correlated with survival, mean observation time, and treatment remission rate. It is important to monitor thyroid hormone levels regularly in patients receiving ICIs.https://www.frontiersin.org/articles/10.3389/fendo.2023.1221723/fullimmune-related adverse eventsimmune check point inhibitorshypothyroidismtransient thyrotoxicosisretrospective study |
| spellingShingle | Yuichiro Iwamoto Tomohiko Kimura Kazunori Dan Mana Ohnishi Haruka Takenouchi Hideyuki Iwamoto Junpei Sanada Yoshiro Fushimi Yukino Katakura Masashi Shimoda Shuhei Nakanishi Tomoatsu Mune Kohei Kaku Hideaki Kaneto Immune checkpoint inhibitor-induced hypothyroidism predicts treatment response in Japanese subjects Frontiers in Endocrinology immune-related adverse events immune check point inhibitors hypothyroidism transient thyrotoxicosis retrospective study |
| title | Immune checkpoint inhibitor-induced hypothyroidism predicts treatment response in Japanese subjects |
| title_full | Immune checkpoint inhibitor-induced hypothyroidism predicts treatment response in Japanese subjects |
| title_fullStr | Immune checkpoint inhibitor-induced hypothyroidism predicts treatment response in Japanese subjects |
| title_full_unstemmed | Immune checkpoint inhibitor-induced hypothyroidism predicts treatment response in Japanese subjects |
| title_short | Immune checkpoint inhibitor-induced hypothyroidism predicts treatment response in Japanese subjects |
| title_sort | immune checkpoint inhibitor induced hypothyroidism predicts treatment response in japanese subjects |
| topic | immune-related adverse events immune check point inhibitors hypothyroidism transient thyrotoxicosis retrospective study |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1221723/full |
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