ECE2024 Eposter Presentations Thyroid (198 abstracts)
Transient thyrotoxicosis and hypothyroidism after combination therapy with pd-1 and ctla-4 inhibitors for cervical cancer
Ketevan Lomidze 1 , 2 , Nino Kikodze 1 , Marine Gordeladze 3 , Tinatin Chikovani 1 & Nino Charkviani 3
1Tbilisi State Medical University, Immunology, T’bilisi, Georgia; 2Israeli-Georgian Medical Research Clinic Healthycore, Clinical Trials Department, Tbilisi, Georgia; 3Tbilisi State Medical University, Endocrinology, T’bilisi, Georgia
Introduction: Mono or combination therapy with immune checkpoint inhibitors for malignancies causes thyroid dysfunction in the form of overt or subclinical hypothyroidism, or thyrotoxicosis. Thyrotoxicosis phase is often transient and in some cases so short that it cannot be diagnosed in time and the patient is examined late when hypothyroidism is confirmed. We describe a case of Cervical Cancer woman who developed transient thyrotoxicosis and later hypothyroidism after combination treatment with CTLA-4 and PD-1 inhibitors.
Case Presentation: A 60-year-old postmenopausal female developed transient thyrotoxicosis- TSH-<0.005 (NR: 0.3-4.0 micro IU/ml) and 2 weeks later Hypothyroidism TSH-220 micro IU/ml 2 months after immunotherapy. The only complaints she had was palpitation and increased blood pressure. Her Anti-TPO was positive, but Anti-Tg and TRab were negative. Initial therapy for thyrotoxicosis was performed with propranolol and after the development of hypothyroidism L-thyroxine replacement therapy was started.
Conclusions: Autoimmune thyroid dysfunctions can be induced by immune checkpoint inhibitors treatment: anti-PD-1, anti-CTLA-4, and anti-PD-L1. An elevated level of clinical suspicion is required for the diagnosis of endocrinopathies due to an upward trend in endocrine disorders among cancer patients receiving immunotherapy. Early management of ICI-induced endocrinopathies improves the quality of oncopatients’ life and continuity of anticancer treatment.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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