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Cited by 190Cancer Immunotherapy and BiomarkersThyroid Disorders and TreatmentsThyroid Cancer Diagnosis and Treatment

Thyroid abnormalities following the use of cytotoxic T-lymphocyte antigen-4 and programmed death receptor protein-1 inhibitors in the treatment of melanoma

Morganstein, D.L., Lai, Z., Spain, L., Diem, S., Levine, D., Mace, C., Gore, M., Larkin, J.·2017·Clinical Endocrinology
DOI 10.1111/cen.13297
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Abstract

CONTEXT: Checkpoint inhibitors are emerging as important cancer therapies but are associated with a high rate of immune side effects, including endocrinopathy. OBJECTIVE: To determine the burden of thyroid dysfunction in patients with melanoma treated with immune checkpoint inhibitors and describe the clinical course. DESIGN AND PATIENTS: Consecutive patients with melanoma treated with either ipilimumab, nivolumab, pembrolizumab or the combination of ipilimumab and nivolumab were identified. Baseline thyroid function tests were used to exclude those with pre-existing thyroid abnormalities, and thyroid function tests during treatment used to identify those with thyroid dysfunction. RESULTS: Rates of overt thyroid dysfunction were in keeping with the published phase 3 trials. Hypothyroidism occurred in 13·0% treated with a programmed death receptor-1 (PD-1) inhibitor and 22·2% with a combination of PD-1 inhibitor and ipilimumab. Transient subclinical hyperthyroidism was observed in 13·0% treated with a PD-1 inhibitor, 15·9% following a PD-1 inhibitor, and 22·2% following combination treatment with investigations suggesting a thyroiditic mechanism rather than Graves' disease, and a high frequency of subsequent hypothyroidism. Any thyroid abnormality occurred in 23·0% following ipilimumab, 39·1% following a PD-1 inhibitor and 50% following combination treatment. Abnormal thyroid function was more common in female patients. CONCLUSION: Thyroid dysfunction occurs commonly in patients with melanoma treated with immune checkpoint inhibitors, with rates, including subclinical dysfunction, occurring in up to 50%.

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Crossref · 10.1111/cen.13297

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  • In typical thyroiditis, thyroid Ultrasound-Doppler shows a heterogeneous hypoechoic parenchyma with low vascularity and low iodine/99mTc uptake on scintigraphy.

    “In typical thyroiditis, thyroid Ultrasound-Doppler shows a heterogeneous hypoechoic parenchyma with low vascularity and low iodine/99mTc uptake on scintigraphy [7].”

    From Graves’ Disease during Immune Checkpoint Inhibitor Therapy (A Case Series and Literature Review) (2021) · cites this paper as [7]

  • In the literature, female gender is described as a risk factor for ICPi-induced thyroid dysfunction, although this is less pronounced than in spontaneous forms and is not described in all studies.

    “In the literature, female gender is described as being a risk factor for ICPi-induced TD, although this is less pronounced than in spontaneous forms [7,46,47] and it is not described in all studies [11,48].”

    From Graves’ Disease during Immune Checkpoint Inhibitor Therapy (A Case Series and Literature Review) (2021) · cites this paper as [7]

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Authors
Morganstein, D. L., Lai, Z., Spain, L., Diem, S., Levine, D., Mace, C., Gore, M., & Larkin, J.
Affiliations
  • Royal Marsden Hospital (GB)
  • Kantonsspital St. Gallen (CH)
  • Chelsea and Westminster Hospital (GB)
Corresponding author
Morganstein, D.L.
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2017-01-27
Volume
86
Issue
4
Pages
614-620
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/cen.13297
OpenAlex
W2560876009
Cited by
190
References
16
Citations by year
2026: 5 · 2025: 2 · 2024: 10 · 2023: 17 · 2022: 21 · 2021: 32 · 2020: 28 · 2019: 40 · 2018: 19 · 2017: 16
FWCI
13.46
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
Keywords
thyroid dysfunction, immune checkpoint inhibitors, melanoma, CTLA-4 inhibitors, PD-1 inhibitors, ipilimumab, nivolumab, pembrolizumab, hypothyroidism, subclinical hyperthyroidism, thyroiditis, immune-related adverse events, endocrine disorders, sex differences
MeSH terms
Ipilimumab, Nivolumab, Adult, Aged, Antibodies, Monoclonal, Female, Humans, Male, Melanoma, Middle Aged, Thyroid Diseases, Thyroid Function Tests, CTLA-4 Antigen, Programmed Cell Death 1 Receptor

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