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Updated: Sep 18, 2025

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Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
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在免疫检查点抑制剂相关的甲状腺功能障碍中描述甲状腺激素替代,基线甲状腺激素和生存
Duaa Abdallah1,2, Jake Johnson1,3,4, Fang Qiu5
1Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
概括
免疫检查点抑制剂治疗可以导致甲状腺功能障碍 (TD). 这种情况的勒沃西洛克辛剂量类似于乳腺性甲状腺功能低下症,并且基线TSH对ICI-TD的预测能力有限.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 是广泛使用的癌症疗法.
- 甲状腺功能障碍 (TD) 是ICI治疗的常见副作用.
- 预测因素,最佳激素替代和ICI-TD的生存关联需要进一步澄清.
研究的目的:
- 在接受ICI的患者中调查甲状腺新发作功能障碍的预测因素.
- 为了确定ICI诱导的甲状腺功能低下症适合的levothyroxine剂量.
- 评估ICI-TD与整体存活率 (OS) 之间的关联,考虑不朽时间偏差 (ITB).
主要方法:
- 对811名接受ICI治疗的成人癌症患者 (2012-2019) 的回顾性队列研究.
- 排除具有先前存在的甲状腺功能低下症的患者.
- 卡普兰-梅尔分析,日志级别测试和考克斯回归模型来评估OS和ITB.
主要成果:
- 15.0%的患者患有ICI-TD;在ICI联合治疗中,这种情况更为频繁.
- 对于明显的甲状腺功能低下症,levothyroxine的剂量为1.41mcg/kg/天,类似于athyreotic甲状腺功能低下症.
- 较高的基线TSH (上正常范围) 与增加的ICI-TD风险相关,但缺乏预测准确性 (AUC<0.6).
结论:
- 对ICI-TD的Levothyroxine剂量与对抗性甲状腺功能低下症的剂量相似.
- 上部正常范围的TSH基线表明ICI-TD风险增加,但不能准确预测它.
- 需要进一步调查ICI-TD和OS之间的关系,特别是在解决ITB之后.
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