Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2017) 49 GP241 | DOI: 10.1530/endoabs.49.GP241

1Clinical Nutrition Unit, Institut Català d’Oncologia (ICO), Hospitalet de Llobregat, Spain; 2Department of Endocrinology, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain; 3Department of Oncology, ICO, Hospitalet de Llobregat, Spain; 4Department of Endocrinology, Hospital Ramón y Cajal, Madrid, Spain.


Introduction: Nivolumab is an antibody that binds to and blocks the activation of programmed-death-receptor 1(PD-1), promoting the activation of T-cells against tumor cells. Thyroid dysfunction (TD) is one of the most common immuno-related adverse events, with incidence up to 10% in patients treated with PD-1/PD-L1 blockade.

Objective: To report our experience of Nivolumab-TD in patients with advanced cancer.

Methods: All patients diagnosed of nivolumab-induced TD during 2016 were included. Data from thyroid function tests, autoimmunity and imaging study before and during nivolumab therapy were recorded.

Results: Twelve cancer patients (5 lung, 4 melanoma, 3 Hodgkin lymphoma) were evaluated. 75% women, mean age: 56.7 year (19–77). Ten patients were treated with nivolumab 3 mg/kg (with or without chemotherapy) every 15 days, 2 patients received combined immunotherapy (nivolumab 1 mg/kg plus ipilimumab 3 mg/kg). Three patients had previously well-controlled thyroid disease (1 overt primary hypothyroidism, 2 subclinical hypothyroidism). Baseline serum TSH and free thyroxine were evaluated in eleven patients, being normal in ten whereas one showed minimal subclinical hypothyroidism. During follow-up, 7 patients (58.3%) developed hyperthyroidism (4 overt and 3 subclinical). Six of them after cycle(C) 2, and 1 after C3. Thyroid antibodies were positive in 3 patients. One overt hyperthyroidism was treated with high dose steroids (prednisone 0.8 mg/kg per day) and nivolumab was temporarily withdrawn. Four of seven hyperthyroid patients became hypothyroid later, needing levothyroxine. Primary hypothyroidism occurred in 5 patients (41.7%) (3 overt and 2 subclinical), between C4-C7. Autoimmunity was positive in 3 hypothyroid patients. No patient discontinued nivolumab due to hypothyroidism.

Conclusions: In our series, hyperthyroidism is more frequent and appears earlier than hypothyroidism. A pattern consistent with a transient thyroiditis followed by hypothyroidism is seen in one-third of patients. Monitoring thyroid function at baseline and before each therapeutic cycle is warranted to detect and treat TD promptly.

Volume 49

19th European Congress of Endocrinology

Lisbon, Portugal
20 May 2017 - 23 May 2017

European Society of Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.