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

• DOI: 10.1007/s00520-024-08445-y
• Publication Date: 2024-04-10T15:02:00Z
• Authors: Stine K. Christensen; Mette L. Winther; Ida J. Laursen; Freja S. Madsen; Carsten Brink; Thomas H. Brix; Eva Ellebaek; Inge Marie Svane; Frederikke S. Hansen; Charlotte Haslund; Olivia K. Laursen; Henrik Schmidt; Ida D. Larsen; Lars Bastholt; Christina H. Ruhl...
• Keywords: Adjuvant Therapy

Abstract 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 irTAEs, and potential impact on treatment efficacy in patients with melanoma receiving adjuvant ICI Methods A national multicenter retrospective cohort resected stage III/IV treated PD-1 inhibitors between November 2018 December 2020. Data were extracted from Danish Metastatic Melanoma Database. irTAEs defined as two consecutive abnormal TSH values subdivided into transient or persistent. Results Of 454 patients, 99 developed an irTAE (21.8%), these 46 (46.5%) 53 persistent (53.5%). Median time was 55 44 days, respectively ( p = 0.57). hyperthyroid phase followed by hypothyroidism seen 73.6% whereas 87% isolated hypo- phase. Multiple variable analysis demonstrated association female sex (HR 2.45; 95% CI 1.63–3.70; < 0.001), but no recurrence-free survival 0.86; 0.50–1.48; 0.587) overall 1.05; 0.52–2.12, 0.891). Conclusions IrTAE a common side effect primarily occurring within first 3 months, high risk persistency. Female strong predictive factor. not improved outcome.