Nivolumab-induced thyroid dysfunction in patients with lung cancer

Area of Science:

• Oncology
• Immunotherapy
• Endocrinology

Background:

• Nivolumab, an anti-PD1 monoclonal antibody, enhances anti-cancer T-cell response.
• While improving survival, nivolumab increases the risk of immune-related adverse events (IRAEs), particularly endocrine IRAEs.

Purpose of the Study:

• To assess the clinical presentation of endocrine IRAEs in lung cancer patients receiving nivolumab.
• To identify potential risk factors and propose management strategies for these IRAEs.

Main Methods:

• A cohort of 40 patients with advanced non-small cell lung cancer (NSCLC) treated with nivolumab was analyzed.
• Focus was placed on the development of endocrine IRAEs (thyroid, hypophyseal, adrenal, pancreatic) and patient outcomes.

Main Results:

• Thyroid function abnormalities occurred in 22.5% of patients (9/40), with 6 developing hypothyroidism and 3 hyperthyroidism.
• Thyroid autoimmunity was negative; hormone levels normalized within six months in hyperthyroid patients.
• No significant differences were found in risk factors between patients with and without thyroid changes.

Conclusions:

• Thyroid function changes are frequent following nivolumab treatment and necessitate vigilant laboratory monitoring.
• Further research is needed to elucidate the mechanisms and clinical significance of these endocrine IRAEs.