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Immune checkpoint inhibitor-related thyroid dysfunction during treatment of lung cancer: a disproportionality
Yaqian Tan1,2, Qi Song3
1Department of Pharmacy, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China.
Background:
Immune checkpoint inhibitors (ICIs) have exhibited remarkable clinical benefits in the treatment of lung cancer, yet a large-scale pharmacovigilance investigation on ICI-related thyroid dysfunction (ICI-TD) remained limited. This study aimed to comprehensively analyze the demographic characteristics of ICI-TD in lung cancer patients and the pharmacovigilance signal patterns of the adverse events (AEs) using data from the Food and Drug Administration Adverse Event Reporting System (FAERS) database.
Methods:
All existing data ranging from January 1st 2014 to March 31st 2026 were retrieved from the FAERS database. In descriptive analysis, the demographic characteristics of ICI-TD in lung cancer patients were collected and categorized. Disproportionality analysis was conducted to evaluate the signal characteristics of ICI-TD by employing three disproportional algorithms, namely reporting odds ratio (ROR), proportional reporting ratio (PRR), and information component (IC).
Results:
A total of 2,001 reports of ICI-TD during treatment of lung cancer were identified after data processing, involving 1,758 patients and 10 ICIs. In general, ICI-TD were mainly reported in male patients (n = 959, 54.55%) and patients aged ≥ 65 years (n = 856, 48.69%; median [lower quartile (Q1), upper quartile (Q3)] = 67 [60, 73]). After data cleaning, we found that reports from 752 patients had valid time-to-onset (TTO) values. The median TTO of ICI-TD was 42 days [Q1, Q3] = [14, 98], and ICI-TD was predominantly reported within 30 days after ICI administration (n = 323, 42.95% of all 752 patients). The vast majority of patients were reported as having serious reaction outcome (n = 1,690, 96.13%). Among all ICIs, nivolumab had the greatest number of ICI-TD reports (a = 655, 32.73% of all 2,001 reports, ROR025 = 2.97, IC025 = 1.32, PRR = 3.21, χ2 = 782.34). The most frequently reported ICI-TD was "hypothyroidism" (a = 901, 45.03% of all 2,001 reports, ROR025 = 4.83, IC025 = 1.22, PRR = 5.36, χ2 = 1,138.77).
Conclusions:
The present study provided a comprehensive overview of the demographic features of patients and pharmacovigilance signal patterns of ICI-TD during the treatment of lung cancer. Our findings would offer a referential perspective for the clinical understanding of the pharmacovigilance signals of ICI-TD.
