Related factors of hypothyroidism induced by programmed death(PD)-1 treatment in elderly patients with cancer
Objective To investigate the factors related to hypothyroidism induced by programmed death(PD)-1 treatment in elderly patients with cancer.Methods A total of 193 older patients(≥60 years old)with advanced solid tumors who received PD-1 treatment between January 2018 and January 2021 at the Department of Oncology of Xiangyang Central Hospital were included in this study.The patients were divided into two groups based on whether they were diagnosed with hypothyroidism after PD-1 treatment:the hypothyroidism group(36 cases)and the non-hypothyroidism group(157 cases).The clinical data of both groups,including age,gender,Eastern Cooperative Oncology Group performance status(ECOG PS),PD-1 inhibitors,thyroid function,and thyroid antibody,were compared to analyze the risk factors associated with hypothyroidism.Results Among the 193 patients,36(18.7％)were diagnosed with hypothyroidism.The study found no significant differences between the two groups in terms of age,gender,ECOG PS,tumor type,and PD-1 type(all P＞0.05).However,significant differences were observed in the baseline levels of thyroid stimulating hormone(TSH)and thyroid antibody subgroups(both P＜0.05).The results of multivariate Logistic regression analysis revealed that the presence of baseline anti-thyroid peroxidase antibody(TPOAb)(OR=20.256,95％CI:5.709-71.868,P＜0.001),the presence of both baseline thyroglobulin antibody(TGAb)and TPOAb(OR=5.853,95％CI:1.475-23.227,P=0.012),and an increase in baseline TSH levels(OR=3.065,95％CI:1.049-8.959,P=0.041)were identified as risk factors for hypothyroidism induced by PD-1 treatment.On the other hand,there was no significant association between the presence of baseline TGAb and the occurrence of hypothyroidism(OR=1.373,95％CI:0.353-5.341,P=0.648).Conclusions The incidence rate of hypothyroidism induced by PD-1 inhibitors is high among elderly patients with cancer.Additionally,the risk of hypothyroidism is higher in patients with elevated baseline TSH and positive TPOAb.Therefore,it is crucial to remain vigilant for the occurrence of hypothyroidism during PD-1 treatment.Timely diagnosis and treatment of hypothyroidism are necessary to minimize the incidence of adverse events.
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