ECE2021 Eposter Presentations Thyroid (43 abstracts)
1Endocrinology Research Center, Moscow, Russia, therapeutic endocrinology, Moscow, Russian Federation; 2N.N. Blokhin National Medical Research Center of Oncology, chemotherapy department, Moscow, Russian Federation
Introduction
Prospective and retrospective trials report the incidence of endocrine adverse events provoked by immune checkpoint inhibitors (ICI) up to 30%. PD-1/PDL inhibitors have a higher incidence of thyroid dysfunction: hypothyroidism 5%-14%, transient hyperthyroidism 3%-5%.
The aim of the study was to assess thyroid function in PD-1/PDL treated patients.
Materials and methods
69 patients were included in the study: 27 melanoma patients and 42 non-small cell lung cancer patients. 46 patients were treated with nivolumab, 10 with pembrolizumab, 9 with atezolizumab and 4 consistently with nivolumab and pembrolizumab or atezolizumab. TSH, free T4 and freeT3 were assessed before ICI therapy (visit 0) and every time before the next administration of the drug. The minimum period of observation was 3 months, so we report results obtained at this point in the study.
Results
Before starting ICI 6 patients had TSH and thyroid hormones levels beyond the limits of the reference range: subclinical hyperthyroidism 2 cases, subclinical hypothyroidism 1 case, overt hyperthyroidism 2 cases, overt hypothyroidism 1 case. In 5 cases we found low T3 (euthyroid sick syndrome). After 3 months of therapy 9 new cases of low T3, 2 cases of persistent hyperthyroidism, 2 cases of subclinical hyperthyroidism and 2 cases of destructive thyroiditis with two phases were revealed.
Conclusions
ICI therapy induced thyroid dysfunction in 21.7%of patients during 3 month after its initiation, however endocrine related adverse events were not considered as an indication for discontinuation of treatment.