IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0216954.html
   My bibliography  Save this article

Incidence, features, and prognosis of immune-related adverse events involving the thyroid gland induced by nivolumab

Author

Listed:
  • Ichiro Yamauchi
  • Akihiro Yasoda
  • Shigemi Matsumoto
  • Yuichi Sakamori
  • Young Hak Kim
  • Motoo Nomura
  • Atsushi Otsuka
  • Toshinari Yamasaki
  • Ryoichi Saito
  • Morimasa Kitamura
  • Toshio Kitawaki
  • Masakatsu Hishizawa
  • Nobuko Kawaguchi-Sakita
  • Toshihito Fujii
  • Daisuke Taura
  • Masakatsu Sone
  • Nobuya Inagaki

Abstract

Background: Blocking the PD-1 pathway induces immune-related adverse events (irAEs) which often involve the thyroid gland (thyroid irAEs). Clinical features of a thyroid irAE including its predictability and relationship to prognosis remain to be elucidated. Methods: Two hundred consecutive patients treated with nivolumab at Kyoto University Hospital between September 1, 2014 and August 31, 2017 were included in a retrospective cohort study. We systematically determined and classified subclinical and overt thyroid irAEs based on data collected of serum free T4 and TSH levels. Baseline characteristics and detailed clinical data were analyzed, and analyses of overall survival (OS) excluded patients censored within 1 month from the first administration of nivolumab. Results: Sixty-seven patients (33.5%) developed thyroid irAEs and these were divided into a subclinical thyroid irAE group (n = 40, 20.0%) and an overt thyroid irAE group (n = 27, 13.5%). Patients with thyroid uptake of FDG-PET before treatment showed high incidences of overt thyroid irAE (adjusted odds ratio 14.48; 95% confidence interval [CI] 3.12–67.19), while the same relationship was not seen with subclinical thyroid irAE. Regarding the total cohort, the thyroid irAE (+) group had a significantly longer median OS than the thyroid irAE (−) group (16.1 versus 13.6 months, hazard ratio [HR] 0.61; 95% CI 0.39–0.93). In 112 non-excluded patients with lung cancer, the thyroid irAE (+) group similarly had a longer median OS than the thyroid irAE (−) group (not reached versus 14.2 months, HR 0.51; 95% CI 0.27–0.92). However, this observation was not seen in 41 non-excluded patients with malignant melanoma (12.0 versus 18.3 months, HR 1.54; 95% CI 0.67–3.43). Conclusions: By thyroid uptake of FDG-PET, overt thyroid irAEs could be predicted before nivolumab therapy. Thyroid irAEs related to good prognosis in lung cancer but might be inconclusive in malignant melanoma.

Suggested Citation

  • Ichiro Yamauchi & Akihiro Yasoda & Shigemi Matsumoto & Yuichi Sakamori & Young Hak Kim & Motoo Nomura & Atsushi Otsuka & Toshinari Yamasaki & Ryoichi Saito & Morimasa Kitamura & Toshio Kitawaki & Masa, 2019. "Incidence, features, and prognosis of immune-related adverse events involving the thyroid gland induced by nivolumab," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-14, May.
    • Handle: RePEc:plo:pone00:0216954
    DOI: 10.1371/journal.pone.0216954
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216954
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0216954&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0216954?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0216954. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.