Occurrence of thyroid dysfunction in patients with advanced NSCLC treated with PD-1 inhibitor and its influencing factors
AN Hao
PEI Xiaosha
HE Xin
CUI Wei
Abstract：Objective To observe the occurrence of thyroid dysfunction in patients with advanced non-small-cell lung cancer(NSCLC)treated with programmed cell death protein-1(PD-1)inhibitor and to analyze its influencing fac-tors.Methods Totally 350 patients with advanced NSCLC who received PD-1 inhibitor treatment were divided into the thyroid dysfunction group and control group based on changes in thyroid function indicators after treatment.General infor-mation and laboratory test results were collected from both groups,and univariate analysis and multivariate Logistic regres-sion were used to analyze the influencing factors of thyroid dysfunction.Results Among 350 patients,77(22.0%)had thyroid dysfunction.The onset time of thyroid dysfunction was between weeks 3-31 of treatment,with a median time of week 9.Fifty-two patients initially presented with clinical hypothyroidism or subclinical hypothyroidism,while 25 patients initially presented with clinical hyperthyroidism or subclinical hyperthyroidism.There was no statistically significant differ-ence in the median time of onset of hyperthyroidism and hypothyroidism(P>0.05).Compared with the control group,the thyroid dysfunction group showed decreased lymphocyte count,increased C-reactive protein,thyroid stimulating hormone levels,and baseline thyroid antibody positivity rate,and longer immunotherapy cycle(all P<0.05).The results of multi-ple Logistic regression analysis showed that baseline thyroid antibody positivity(OR=7.750,95%CI:3.878-15.487)and immunotherapy cycle≥6 weeks(OR=1.225,95%CI:1.158-1.296)were independent risk factors for thyroid dys-function(all P<0.05).Conclusions The incidence of thyroid dysfunction in patients with advanced NSCLC treated with PD-1 inhibitor is relatively high,and hypothyroidism is more common.Basal thyroid antibody positivity and long im-munotherapy cycle(≥6 weeks)are risk factors for thyroid dysfunction.
Keywords：PD-1 inhibitornon-small-cell lung cancerthyroid dysfunction
Publication Date：2024-11-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 33-37 )