ECE2017 Oral Communications Thyroid Disease 2 (5 abstracts)
Thyroid dysfunction during the use of PD-1/PD-L1 blockade predicts its therapeutic response in the patients with advanced non-small cell lung cancer
Hye In Kim 1 , Tae Hyuk Kim 1 , Hye Won Jang 2 , Young Nam Kim 1 , Hosu Kim 1 , So Young Park 1 , Sun Wook Kim 1 & Jae Hoon Chung 1
1Samsung Medical Center, Seoul, Republic of Korea; 2Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Background: PD-1/PD-L1 blockade is one of the promising drugs in the treatment of advanced non-small cell lung cancer (NSCLC). and predicting drug effect is important due to unique pattern of response. Immune-related adverse event (IRAE) might be associated with favorable clinical outcome. Thyroiditis is the most common IRAE which can be easily detected with the measurement of thyroid hormone levels. However, the relationship between thyroid dysfunction during the use of PD-1/PD-L1 blockade and its therapeutic response has not been well demonstrated in advanced NSCLC patients.
Methods: A total 53 patients with stage IV NSCLC treated with PD-1/PD-L1 blockade were enrolled. Patients were categorized into thyroid dysfunction and euthyroid group. Overall survival (OS) and progression free survival (PFS) of two groups were compared. Hazard ratio (HR) adjusting patients, tumor, and drug factors were analyzed using Cox proportional hazard model. Response rate (RR) and durable RR were assessed according to thyroid dysfunction and its severity.
Results: OS (mean 148.5±82.6 vs 82.0±65.1, log-rank P=0.003) and PFS (143.2±88.2 vs 68.0±50.0, log-rank P=0.001) were significantly longer in the thyroid dysfunction group. After adjustment for age, sex, smoking status, tumor stage, and drug type, adjusted HR (95% CI) for overall death and progression disease were 0.08 (0.01–0.65) and 0.29 (0.12–0.69) compared with euthyroid group. RR (36.0 vs 10.7%, P=0.028) and durable RR (28.0 vs 0%, P=0.003) were more frequent in the thyroid dysfunction group. Severity of thyroid dysfunction was also associated with RR (P for trend =0.018) and durable RR (P for trend =0.001).
Conclusions: Thyroid dysfunction during the use of PD-1/PD-L1 blockade and its severity predict its favorable disease outcome in NSCLC patients. Therefore, regular measurement of thyroid hormone levels during the use of PD-1/PD-L1 blockade could be the good biomarker of immune monitoring.
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Endocrine Abstracts
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