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S. Tsagouli

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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      186P - Thyroid toxicity as an immune-related adverse event in patients with non-small cell lung cancer during treatment with immune checkpoint inhibitors (ID 364)

      12:30 - 13:00  |  Author(s): S. Tsagouli

      • Abstract
      • Slides

      Programmed cell death protein 1(PD-1)/programmed death-ligand 1(PD-L1) inhibitors have improved outcomes for cancer patients, in exchange for novel immune-related adverse events (irAEs), including thyroid toxicity that is documented in up to 10% of cases.

      The medical records of 42 patients with stage IV non-small cell lung cancer (NSCLC), treated with anti-PD-1/PD-L1 monoclonal antibodies, were retrospectively evaluated. Thyroid function tests (TFTs) were assessed both at baseline and at regular 6-week intervals. Demographics and clinicopathological features of patients and frequency, grade, clinical course and management of thyroid toxicity were recorded and analyzed.

      Thyroid toxicity was observed in 12 cases (28.6%). 6 patients developed hyperthyroidism, which was only transient in 4 of them (66.7%), before advancing to hypothyroidism. De novo hypothyroidism ensued in 2 patients. The remaining 4 patients were hypothyroid, receiving hormone replacement therapy at baseline and needed dose adjustment due to thyroid toxicity. Median time on treatment until development of thyroid toxicity was 47 days (range from 15 to 251 days). Grade I events were recorded in 6 patients (50%), grade II in 5 (41.7%) and only one patient (8.3%) experienced grade III thyroid toxicity. Oral levothyroxine was prescribed for symptomatic hypothyroidism. B-blockers in combination with low doses of oral methylprednisolone (a maximum of 16 mg per day) were administered in symptomatic hyperthyroid patients. TFTS became normal in 11 patients; 4 individuals needed long-lasting hormone replacement. None of our patients had to permanently discontinue anti-cancer immunotherapy.

      A relatively high rate of immune-mediated thyroid toxicity was observed in our cohort. Low doses of oral methylprednisolone were effective in controlling clinical hyperthyroidism, while grade III/IV thyroid toxicity was rare. Further studies are warranted to explore the possibility of an increased susceptibility to immune-mediated thyroid-related adverse events in the Greek population, and the factors underlying this phenomenon.

      Clinical trial identification:

      Legal entity responsible for the study:
      University of Athens

      Has not received any funding

      All authors have declared no conflicts of interest.

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