Frequency and characteristics of immune-related thyroid adverse events in patients with resected stage III/IV melanoma treated with adjuvant PD-1 inhibitors: a national cohort study

Frequency and characteristics of immune-related thyroid adverse events in patients with resected stage III/IV melanoma treated with adjuvant PD-1 inhibitors: a national cohort study

Purpose Immune-related thyroid adverse events (irTAEs) occur frequently following immune checkpoint inhibitor (ICI) therapy. The purpose of this study is to provide knowledge about the incidence, clinical timeline characteristics, associated factors of irTAEs, and potential impact on treatment effic...

Full description

Saved in:
Bibliographic Details
Published in:Supportive care in cancer Vol. 32; no. 5; p. 281
Main Authors: Christensen, Stine K., Winther, Mette L., Laursen, Ida J., Madsen, Freja S., Brink, Carsten, Brix, Thomas H., Ellebaek, Eva, Svane, Inge Marie, Hansen, Frederikke S., Haslund, Charlotte, Laursen, Olivia K., Schmidt, Henrik, Larsen, Ida D., Bastholt, Lars, Ruhlmann, Christina H.
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-05-2024
Springer Nature B.V
Subjects:
Adjuvants, Immunologic
Adjuvants, Pharmaceutic
Cohort analysis
Cohort Studies
Female
Humans
Hyperthyroidism
Immune Checkpoint Inhibitors - adverse effects
Immunotherapy
Inhibitor drugs
Medicine
Medicine & Public Health
Melanoma
Melanoma - drug therapy
Nursing
Nursing Research
Oncology
Pain Medicine
Rehabilitation Medicine
Retrospective Studies
Side effects
Skin Neoplasms - drug therapy
Thyroid gland
Adjuvant
Immune checkpoint inhibitors
Immune-related adverse events
PD-1 inhibitor
Immune-related thyroiditis
Melanoma
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose Immune-related thyroid adverse events (irTAEs) occur frequently following immune checkpoint inhibitor (ICI) therapy. The purpose of this study is to provide knowledge about the incidence, clinical timeline characteristics, associated factors of irTAEs, and potential impact on treatment efficacy in patients with melanoma receiving adjuvant ICI therapy. Methods A national multicenter retrospective cohort study of patients with resected stage III/IV melanoma treated with adjuvant PD-1 inhibitors between November 2018 and December 2020. Data were extracted from the Danish Metastatic Melanoma Database. The irTAEs were defined as two consecutive abnormal TSH values and subdivided into transient or persistent. Results Of 454 patients, 99 developed an irTAE (21.8%), of these were 46 transient (46.5%) and 53 persistent (53.5%). Median time to transient and persistent irTAE was 55 and 44 days, respectively ( p  = 0.57). A hyperthyroid phase followed by hypothyroidism was seen in 73.6% of persistent irTAEs, whereas 87% of transient irTAEs developed an isolated hypo- or hyperthyroid phase. Multiple variable analysis demonstrated an association between irTAE and female sex (HR 2.45; 95% CI 1.63–3.70; p  < 0.001), but no association with recurrence-free survival (HR 0.86; 95% CI 0.50–1.48; p  = 0.587) or overall survival (HR 1.05; 95% CI 0.52–2.12, p  = 0.891). Conclusions IrTAE is a common side effect to PD-1 inhibitors primarily occurring within the first 3 months, with a high risk of persistency. Female sex is a strong predictive factor. IrTAE was not associated with improved clinical outcome.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-024-08445-y