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Adequacy of Immune Checkpoint Inhibitor-Associated Thyroid Function Monitoring After Therapy.

Maria A Velez1, Elliot S Kang1, Chester A Thompson1

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Post-immune checkpoint inhibitor (ICI) thyroid dysfunction is common, affecting 11.6% of monitored patients. Inadequate surveillance may lead to under-recognition of this endocrine adverse event after cancer therapy.

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Area of Science:

  • Endocrinology
  • Oncology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) are widely used cancer therapies.
  • Thyroid dysfunction is a known endocrine side effect of ICIs.
  • Limited data exist on thyroid dysfunction occurring after ICI treatment cessation.

Purpose of the Study:

  • To investigate the incidence and recognition of thyroid dysfunction after ICI therapy.
  • To determine if post-ICI thyroid dysfunction is under-recognized due to insufficient monitoring.

Main Methods:

  • Retrospective analysis of 3,626 patients treated with ICIs.
  • Evaluation of clinically significant thyroid dysfunction before, during, and after ICI therapy.
  • Assessment of thyroid laboratory surveillance rates post-treatment.

Main Results:

  • Clinically acted-upon thyroid dysfunction occurred in 8.1% during and 4.4% after ICI therapy.
  • Among patients without prior dysfunction, 11.6% developed post-ICI thyroid dysfunction.
  • 48.6% of patients lacked post-ICI thyroid lab results; 30% with abnormal pre-discontinuation TSH developed dysfunction.

Conclusions:

  • Post-ICI thyroid dysfunction is frequent and potentially under-recognized.
  • Patients with abnormal TSH before discontinuation and those on therapy for ≤9 months warrant closer surveillance.
  • Enhanced post-treatment monitoring is crucial for managing ICI-induced endocrine adverse events.