Thyroid disorders associated with immune control point inhibitors

Area of Science:

• Endocrinology
• Oncology
• Immunology

Background:

• Immune checkpoint inhibitors (ICPI) enhance anti-tumor responses but can cause immune-related adverse events.
• Thyroid dysfunction (TD) is a frequent endocrine complication of ICPI therapy.
• Understanding TD presentation and course is crucial for managing cancer patients on ICPI.

Purpose of the Study:

• To characterize the clinical presentation and evolution of thyroid dysfunction in cancer patients treated with ICPI.
• To analyze the timing and types of TD based on ICPI regimen (monotherapy vs. double therapy).

Main Methods:

• Retrospective, multicenter study involving 120 cancer patients with TD associated with ICPI.
• Data collected from six Spanish hospitals.
• Analysis of clinical presentation, analytical alterations, and treatment course.

Main Results:

• Thyroid dysfunction occurred with similar frequency as hypothyroidism (49%) and hyperthyroidism (51%).
• TD onset was earlier in patients receiving double ICPI therapy compared to monotherapy.
• 80% of patients experienced a shift in thyroid function during follow-up, often from hyperthyroidism to hypothyroidism.

Conclusions:

• Thyroid dysfunction is a common adverse event in patients treated with ICPI, presenting as both hypo- and hyperthyroidism.
• Earlier detection of TD is associated with a higher prevalence of hyperthyroidism.
• The distinct presentation of TD in double ICPI therapy necessitates adjusted monitoring protocols.