Frequency of Thyroid Dysfunction in Cancer Patients on Immunotherapy
DOI:
https://doi.org/10.70749/ijbr.v3i7.2641Keywords:
Thyroid Dysfunction, Cancer, ImmunotherapyAbstract
Background: Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment by enhancing the immune system’s ability to target tumor cells. ICIs include PD-1, PD-L1, and CTLA-4 inhibitors. Despite their efficacy, ICIs are associated with immune-related adverse events, with thyroid dysfunction being the most common endocrine complication. Objective: To determine the frequency of thyroid dysfunction in cancer patients on immunotherapy. Material and Methods: This prospective cohort study was conducted at Liaquat National Hospital, Karachi, from 28/11/24 to 27/5/25. A total of 89 patients aged 19–70 years were enrolled. Thyroid function was monitored via TSH and FT4 levels at baseline and every 2–3 weeks during treatment with immune checkpoint inhibitors. Data were analyzed using SPSS, with statistical significance set at p ≤ 0.05. Stratification controlled for confounders like age, gender, cancer type, and comorbidities. Results: The mean age was 54.4±11.7 years with predominance of females (69.7%). Breast cancer was the most common malignancy. Pembrolizumab combined with chemotherapy was the most frequently administered treatment. Thyroid dysfunction was observed in 14.6% of patients, with hypothyroidism being the most prevalent subtype (7.9%). Thyroid dysfunction typically developed within 2 to 11 weeks of initiating immunotherapy, depending on the agent used. No significant associations were found between thyroid dysfunction and patients’ socio-demographic or clinical characteristics. Conclusion: Thyroid dysfunction was observed in a small group of cancer patients receiving immune checkpoint inhibitors, with onset varying by drug. No associations were found with patient characteristics.
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