Clinical Characteristics and Influencing Factors of Nivolumab-related Thyroid Dysfunction
Objective To find out about the incidence and possible influencing factors of nivolumab-related thyroid dysfunction in patients with digestive tract malignant tumor.Methods Patients with gastric or esophageal malignant tumor who had been treated with nivolumab between December 2020 and Decem-ber 2022 were selected in this study,who were divided into two groups based on whether they had experi-enced thyroid dysfunction during treatment.Their electronic medical records were collected and their demographics,medical history and treatment courses were recorded,especially thyroid function parameters and complete blood count before and after nivolumab treatment.The Common Terminology Criteria for Adverse Events(Version 5.0)were used to determine the severity of adverse events.Univariate analysis was used to compare the variables and binary logistic regression analysis was performed to identify inde-pendent predictors of nivolumab-related thyroid dysfunction.Results Forty patients were enrolled.The incidence of thyroid dysfunction was 20.00%,that of subclinical hyperthyroidism or hyperthyroidism was 12.50%and that of hypothyroidism was 17.50%.Univariate analysis found that baseline thyroid autoantibody positivity(P=0.001)and baseline lymphocyte count(P=0.042)were significantly different between the two groups.In addition,baseline thyroid autoantibody positivity(odds ratio=24.996,95%CI 2.043-305.776)was identified as an independent risk factor for nivolumab-related thyroid dysfunction.Conclusion Nivolumab-related thyroid dysfunction is a very common adverse reaction of nivolumab.Base-line thyroid autoantibody positivity is an independent risk factor for nivolumab-related thyroid dysfunction so that clinical monitoring of FT4,TSH and thyroid autoantibodies is necessary.
nivolumabnivolumab-related thyroid disfuctionadverse drug reaction
NETL
NSTL
万方数据
