Abstract 862P
Background
Among the endocrinopathies the incidence of thyroid disfunction in cancer patients receiving immune checkpoint inhibitors (ICHs) is the highest. The aim of this study was to evaluate the risk of treatment-related hypothyroidism across different ICH regimens that are applied for advanced melanoma treatment. PubMed was searched for phase 2 and 3 randomised clinical trials (RCTs) dedicated to the treatment of advanced melanoma with different ICH regimens. The articles were published from 1/1/2010 until 31/12/2020. 10 RCTs were selected from 124 articles and assessed for the overall risk of bias.
Methods
10 selected RCTs with 13 different advanced melanoma ICH treatment regimens, that involved a total of 7012 patients, were simultaneously compared using Bayesian network meta-analysis with Markov chain Monte Carlo simulation with non-informative prior distribution and random-effects generalized linear models. Pooled odds ratios (ORs) with 95% credible intervals (CrIs) were used to estimate the risk of hypothyroidism. The ranking of regimens was established using the surface under the cumulative ranking curve (SUCRA).
Results
Overall, comparing the most clinically applied ICH regimens for advanced melanoma treatment such as nivolumab, 3 mg/kg, every 2 weeks, pembrolizumab, 200 mg, every 3 weeks, and the combination of nivolumab, 1 mg/kg, and ipilimumab, 3 mg/kg, every 3 weeks, the lowest risk of any grade treatment-related hypothyroidism AE was associated with pembrolizumab (SUCRA, 97.9%). Although there were no statistically significant differences between these treatments according to ORs with 95% CrIs, the overall SUCRA ranking revealed a tendency that nivolumab (SUCRA, 39.2%) was associated with lower risk of any grade treatment-related hypothyroidism AE than the nivolumab in combination with ipilimumab (SUCRA, 23.7%). No significant differences were identified between treatment regimens associated with severe (grade 3-5) hypothyroidism AE.
Conclusions
Obtained SUCRA ranking tendencies suggest that for patients with advanced melanoma, who have a risk of hypothyroidism, pembrolizumab, 200 mg, every 3 weeks, may be the preferred treatment regimen among the compared ICH.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.