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免疫检查点抑制剂诱导的甲状腺功能低下症的可逆性
Jeongmin Seo1, Min Joo Kim2,3, Minsu Kang1
1Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Endocrine-related cancer
|November 7, 2025
概括
免疫检查点抑制剂诱导的甲状腺功能低下症的恢复是罕见的. 早期癌症患者和在接受Levothyroxine (LT4) 治疗之前TSH水平较低的患者,更有可能停止LT4治疗.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 是一种重要的癌症疗法.
- 甲状腺功能低下症是ICI常见的免疫相关不良事件.
- ICI诱导的甲状腺功能低下症和Levothyroxine (LT4) 停药的可逆性尚未得到充分了解.
研究的目的:
- 调查因免疫检查点抑制剂 (ICI) 治疗而出现甲状腺功能低下症的患者中停止服用勒沃西 (LT4) 的速度和预测因素.
- 评估该患者群体中LT4退出的可能性.
主要方法:
- 对从2016年1月到2024年3月接受ICI治疗的3,753名患者的回顾性分析.
- 确定了254名 (6.8%) 患有需要LT4.4的甲状腺功能低下症的患者.
- 分析了LT4停药率,并使用多变量考克斯回归来确定预测因素.
主要成果:
- 只有5.4%的停止ICI治疗的患者也停止了LT4.
- 没有继续ICI的患者停止了LT4.
- 早期癌症治疗 (HR 13.40) 和基线TSH <20 μIU/mL (HR 15.16) 预测LT4的停止.
结论:
- 从ICI诱导的甲状腺功能低下症中恢复,以LT4停止为标志,并不常见.
- 患有早期癌症和较低TSH基线水平的患者更有可能停止LT4.
- 对管理ICI诱导的甲状腺功能低下症的进一步研究是有必要的.
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