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Development of thyroid dysfunction is associated with clinical response to PD-1 blockade treatment in patients with

Hye In Kim1, Mijin Kim2, Se-Hoon Lee3

  • 1Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Oncoimmunology
|January 4, 2018
PubMed

Insights

Thyroid dysfunction during programmed cell-death protein 1 (PD-1) blockade therapy is linked to better treatment outcomes in non-small cell lung cancer. This immune-related adverse event may serve as a predictive marker for improved survival and response rates.

Area of Science:

  • Oncology
  • Immunotherapy
  • Endocrinology

Background:

  • Programmed cell-death protein 1 (PD-1) and its ligand (PD-L1) inhibitors are effective cancer treatments.
  • Immune-related adverse events (irAEs) can correlate with positive clinical outcomes.
  • Thyroid dysfunction is a common irAE observed during PD-1 blockade therapy.

Purpose of the Study:

  • To investigate the association between thyroid dysfunction and treatment efficacy in non-small cell lung cancer (NSCLC) patients receiving PD-1 blockade.
  • To determine if thyroid dysfunction serves as a predictive factor for overall survival (OS) and progression-free survival (PFS).

Main Methods:

  • Retrospective analysis of 58 stage IV NSCLC patients treated with PD-1 blockade.
  • Categorization of patients into thyroid dysfunction and euthyroid groups.
  • Comparison of OS and PFS between groups, with adjustments for patient, tumor, and medication factors using Cox proportional hazard modeling.

Main Results:

  • Patients with thyroid dysfunction exhibited significantly longer OS (median 118.0 vs. 71.0 days) and PFS (median 118.0 vs. 61.0 days).
  • Thyroid dysfunction was identified as an independent predictive factor for favorable outcomes (adjusted HR for death: 0.11; for progression: 0.38).
  • The severity of thyroid dysfunction correlated with a higher durable control rate (P for trend = 0.008).

Conclusions:

  • Thyroid dysfunction occurring during PD-1 blockade therapy is associated with enhanced treatment response in advanced NSCLC.
  • Monitoring thyroid function may offer valuable insights for immune monitoring and predicting treatment success in these patients.
Keywords:
Programmed Cell Death 1biomarkersimmunotherapynon-small cell lung cancerthyroid

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