Abstract 1850P
Background
Cancer immunotherapy, particularly treatment with immune checkpoint inhibitors, has become an important treatment of many cancer types. Use of immune checkpoint inhibitors is often associated with immune-related adverse events (irAEs). Endocrine dysfunction is one of the common irAEs. Majority of the studies on immune-related endocrine dysfunction (irED) were conducted in Western countries and there is few Asian patients data. This study aims to review the frequency and nature of irED in Chinese.
Methods
A retrospective review of all Chinese patients treated for cancer with anti-PD1/ anti-PDL1 or anti-CTLA4 or combination therapy (with chemotherapy or targeted agent) in Department of Clinical Oncology, Queen Mary Hospital, from January 2014 to December 2019 was performed. Demographic data, cancer type and stage, drug treatment, details about irEDs were extracted.
Results
Total 953 patients (male: 603, 64%; median age: 62.0 years) received immune checkpoint inhibitors during the study period. 570 patients (59.8%) used mono-immunotherapy, 133 (14.0%) used dual-immunotherapy, 206 (21.6%) used immunotherapy with chemotherapy and 78 (8.2%) used immunotherapy with targeted agent. 168 patients (17.63%) had hypothyroidism with median onset time 9.9+/-17.5 weeks. 71 patients (11.8%) had hyperthyroidism with median onset time 8.1+/-25.3 weeks. 82 patients (8.6%) had hypocortisolism with median onset time 21.2+/-26.6 weeks. 69 patients (7.2%) had hypercortisolium with median onset time 9.6+/-33.1 weeks. Further analysis on patients developed hypothyroidism was showed in the Table. Table: 1850P
immune-related hypothyroidism
| Number of patients with hypothyroidism | Percentage | Median onset time (week) | Standard deviation (week) | |
| mono-immunotherapy | 92/570 | 16.1% | 10.1 | 18.3 |
| dual-immunotherapy | 29/133 | 21.8% | 12.4 | 15.1 |
| Immunotherapy + chemotherapy | 29/206 | 14.1% | 12.0 | 20.8 |
| Immunotherapy + targeted agent | 25/78 | 32.1% | 8.4 | 11.4 |
Conclusions
Immune checkpoint inhibitors are frequently associated with irEDs with median onset time 8-21 weeks depending on type of irED. Combination of immunotherapy with targeted agents or dual immunotherapy had higher risk of hypothyroidism. Regular endocrine function monitoring should be performed especially in the first six months of treatment.
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.