Risk factors for PD-1/PD-L1 inhibitor related thyroid dysfunction in patients with advanced non-small cell lung cancer
JIANG Kun
LI Yisong
LI Wenhai
Abstract：Objective To explore the risk factors for PD-1/PD-L1 inhibitor related thyroid dysfunction in patients with advanced non-small cell lung cancer (NSCLC).Methods A total of 86 patients with advanced NSCLC who underwent PD-1/PD-L1 inhibitor treatment in Xi'an International Medical Center Hospital from January 2021 to January 2024 were selected and divided into a normal thyroid function group and an abnormal thyroid function group based on whether thyroid dysfunction occurred after treatment.Univariate analysis of the general clinical data of the two groups was conducted to screen the risk factors for the occurrence of PD-1/PD-L1 inhibitor related thyroid dysfunction,and multivariate logistic regression analysis was used to analyze the independent risk factors for PD-1/PD-L1 inhibitor related thyroid dysfunction.Results Among the 86 patients,32 (37.21％) experienced thyroid dysfunction,with subclinical hypothyroidism being the most common ( 40.63％) .The Common Classification Criteria for Adverse Events ( CTCAE ) mainly focus on levels 1 to 3.Eight cases underwent left thyroid replacement therapy.Univariate analysis showed that age,radiotherapy history,combined anti angiogenic therapy,baseline TSH,TgAb,NLR,and PLR levels were associated with PD-1/PD-L1 inhibitor related thyroid dysfunction in the two groups (P<0.05).Multivariate logistic regression analysis showed that radiotherapy history,combined anti-angiogenic therapy,baseline TSH,and NLR levels were independent risk factors for PD-1/PD-L1 inhibitor related thyroid dysfunction.Conclusions The incidence of thyroid dysfunction is higher in advanced NSCLC patients treated with PD-1/PD-L1 inhibitors.Previous radiation therapy history,combined anti angiogenic therapy,high baseline TSH,and low NLR are independent risk factors for thyroid dysfunction and should be of clinical concern.
Keywords：Non-small cell lung cancerThyroid dysfunctionImmunotherapyPD-1/PD-L1 inhibitorsImmune related adverse reactionsRisk factors
Publication Date：2024-12-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 566-570 )