单位:[1]Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA[2]Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA[3]Department of Endocrinology, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China[4]Department of Biostatistics and Computational Biology, Dana-F arber Cancer Institute, Boston, MA[5]Department of Medical Record & Statistics, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China[6]Department of Endocrinology and Metabolism, China-Japan Friendship Hospital, Beijing, China[7]Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China[8]Division of Endocrinology, Diabetes and Metabolism, Keck School of Medicine, University of Southern California, Los Angeles, CA
Thyroid disorders have emerged as one of the most common immune-related adverse events (irAE), yet optimum management and biomarkers to predict vulnerable individuals remain to be explored. High-dose glucocorticoid (HDG) therapy is routinely recommended for irAEs. However, systematic analysis of the impact of glucocorticoid therapy on the outcome of immune-checkpoint inhibitor (ICI)-induced thyroid disorders is lacking. We analyzed 151 patients with or without ICI-related thyroid disorders. We divided the patients with ICI-related thyroid disorders into two subgroups: those with and without HDG treatment. Our results showed no significant differences between HDG and no HDG groups in terms of the median duration of thyrotoxicosis: 28 (range, 7-85) and 42 (range, 14-273) days, the median time to conversion from thyrotoxicosis to hypothyroidism: 39 days (range, 14-169) and 42 days (range, 14-315) days, the median time to onset of hypothyroidism: 63 (range, 21-190) and 63 (range, 14-489) days, and the median maintenance dose of levothyroxine: 1.5 (range, 0.4-2.3) mu g/kg/day, and 1.3 (range, 0.3-2.5) mu g/kg/day. The median pretreatment TSH was 2.3 (range, 0.3-5.2) mIU/L and 1.7 (range, 0.5-4.5) mIU/L in patients with and without ICI-related thyroid disorders, respectively. Baseline TSH was significantly higher in patients who developed ICI-related thyroid disorders (P = 0.05). Subgroup analysis revealed significantly higher baseline TSH in male but not in female patients with ICI-induced thyroid dysfunction. Our results show that HDG treatment did not improve the outcome of ICI-related thyroid disorders.
基金:
NIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [K08 HD070957]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81300698]
第一作者单位:[1]Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA[3]Department of Endocrinology, Shanxi Provincial People's Hospital, Taiyuan, People's Republic of China
通讯作者:
通讯机构:[1]Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA[*1]Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115 USA.
推荐引用方式(GB/T 7714):
Ma Chanjuan,Hodi F. Stephen,Giobbie-Hurder Anita,et al.The Impact of High-Dose Glucocorticoids on the Outcome of Immune-Checkpoint Inhibitor-Related Thyroid Disorders[J].CANCER IMMUNOLOGY RESEARCH.2019,7(7):1214-1220.doi:10.1158/2326-6066.CIR-18-0613.
APA:
Ma, Chanjuan,Hodi, F. Stephen,Giobbie-Hurder, Anita,Wang, Xiaocheng,Zhou, Jing...&Min, Le.(2019).The Impact of High-Dose Glucocorticoids on the Outcome of Immune-Checkpoint Inhibitor-Related Thyroid Disorders.CANCER IMMUNOLOGY RESEARCH,7,(7)
MLA:
Ma, Chanjuan,et al."The Impact of High-Dose Glucocorticoids on the Outcome of Immune-Checkpoint Inhibitor-Related Thyroid Disorders".CANCER IMMUNOLOGY RESEARCH 7..7(2019):1214-1220