Thyroid Dysfunction in Lung Cancer Patients Treated with Immune Checkpoint Inhibitors (ICIs): Outcomes in a...

Area of Science:

• Oncology
• Endocrinology
• Immunotherapy

Background:

• Immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 are revolutionizing lung cancer treatment.
• Thyroid dysfunction is a known immune-related adverse event (irAE) associated with ICIs.
• Understanding demographic and clinical associations with ICI-induced thyroid dysfunction is crucial for patient management.

Purpose of the Study:

• To characterize thyroid dysfunction in a multiethnic lung cancer cohort treated with ICIs.
• To investigate associations between thyroid dysfunction and baseline characteristics, including race.
• To evaluate the impact of thyroid dysfunction on progression-free survival (PFS).

Main Methods:

• Retrospective chart review of 205 lung cancer patients receiving anti-PD1 or PD-L1 agents.
• Multivariate Cox proportional hazards models to assess time to thyroid dysfunction by race.
• Log-rank test to compare PFS at 24 weeks between patients with and without thyroid dysfunction.

Main Results:

• 37.1% (76/205) of patients developed thyroid dysfunction.
• Thyroid dysfunction occurred at similar rates across racial groups (p=0.92).
• Black patients showed higher rates of thyrotoxicosis compared to White and Hispanic patients (p=0.016).
• No significant association was found between gender, concurrent chemotherapy, and thyroid dysfunction.
• Progression-free survival (PFS) was similar for patients with and without thyroid dysfunction (p=0.353).

Conclusions:

• While overall thyroid dysfunction rates were similar across races, Black race emerged as a risk factor for thyrotoxicosis.
• Immune-related thyroid dysfunction did not significantly affect PFS in this cohort.
• Further research is needed to elucidate the mechanisms underlying race-specific irAE development.