Title:Endocrine Adverse Events Related To Immune Checkpoint Inhibitor Treatment: Relationship Between Antibodies and Severity of Thyroid Dysfunction
Volume: 24
Issue: 14
Author(s): María Miguélez González*, Alba Galdón Sanz-Pastor, Roberto Áñez Gómez, Noemi Brox Torrecilla, Diego Muñoz Moreno, Laura González Fernández, Alejandra Maricel Rivas, Aurelio López Guerra, Rosa Álvarez, José Ángel Arranz, Iván Márquez Rodas, Vicente Escudero, María Sanjurjo, Javier Martín Vallejo, Miguel Martín and Olga González Albarrán
Affiliation:
- Department of Endocrinology, Hospital General Universitario Gregorio, Marañón, Madrid, Spain
Keywords:
ICI, endocrinopathies, thyroid antibodies, severity, PFS, thyroid dysfunction.
Abstract:
Objective: The purpose of this study was to identify predictive and risk factors for the
development of immune-related endocrinopathies and to analyze the incidence and characteristics
of immune-related endocrinopathies in our population.
Design: A retrospective, single-centre cohort carried out at Gregorio Marañón Hospital between
January 2018 -December 2019.
Methods: A total of 163 patients were enrolled. In January 2018 and December 2019, we treated
patients who underwent ICI treatment in the Medical Oncology Department of General University
Hospital Gregorio Marañón, a tertiary care public hospital in Madrid, as part of an observational,
retrospective, single-center cohort study.
Results: Endocrinopathies were diagnosed in 19.5% of the patients (n = 32). The tumours with
the highest incidence of endocrinopathies were non-small cell lung cancer (25,9%), kidney cell
cancer (25%) and hepatocarcinoma (20%). Among the 32 patients who developed endocrinopathy,
18,8%, 19,13%, and 21,28% received anti-CTLA-4, anti-PD-1 and anti-PDL-1, respectively.
Thyroid dysfunction was the most frequent endocrinopathy (12,8%). A higher percentage of
patients with negative antiTPO and antiTG antibodies developed G1 hypothyroidism compared
to patients with positive antibodies who developed a higher proportion of G2 hypothyroidism.
The presence of an initial phase of thyrotoxicity was not related to greater severity. We observed
longer progression-free survival in patients who developed thyroid dysfunction.
Conclusion: Pre-existing antibodies were independently associated with endocrinopathies.
Moreover, our study let us conclude that the presence of thyroid autoantibodies may be related
to its severity. It is important to determine anti-thyroid antibodies prior to the start of immunotherapy
as a risk factor for thyroid dysfunction, which in turn is a prognostic marker.
