Karhapää Hanna, Mäkelä Siru, Laurén Hanna, Jaakkola Marjut, Schalin-Jäntti Camilla, Hernberg Micaela
Medical Faculty, University of Helsinki, Helsinki, Finland.
Department of Oncology, Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland.
Endocr Connect. 2022 Feb 4;11(2):e210562. doi: 10.1530/EC-21-0562.
Immune checkpoint inhibitors (ICI) can cause endocrine adverse events. However, endocrine adverse events (AEs). However, endocrine AEs could be related to better treatment outcomes. Our aim was to investigate whether this holds true in a real-world setting of metastatic melanoma patients.
A retrospective single-institution study.
We included 140 consecutive metastatic melanoma patients treated with ICI between January 2012 and May 2019. We assessed the endocrine toxicity and the best possible treatment outcomes from electronic patient records, including laboratory parameters and radiological images.
Of the treated patients, 21 patients (15%) were treated with ipilimumab, 46 (33%) with nivolumab, 67 (48%) with pembrolizumab, and 6 (4%) with combination therapy (ipilimumab + nivolumab). Endocrine AEs appeared in 29% (41/140) patients. Three patients had two different endocrine AEs. Thyroid disorders were the most common: 26% (36/140), followed by hypophysitis: 4% (5/140). Three subjects (2%, 3/140) were diagnosed with autoimmune diabetes. Three patients had to terminate treatment due to endocrine toxicity. Radiological manifestations of endocrine AEs were found in 16 patients (39%, 16/41). Endocrine toxicity was associated with significantly better treatment outcomes. Median progression-free survival (8.1 months, range 5.1-11.1 months vs 2.7 months, range 2.4-3.0 months, P < 0.001), and median overall survival (47.5 months, range 15.5-79.5 months vs 23.7 months, range 15.3-32.1 months, P = 0.035) were longer for patients experiencing endocrine AEs.
The higher number of endocrine AEs suggest that regular laboratory monitoring aids in AE detection. Endocrine AEs in metastatic melanoma may correlate with better treatment outcomes.
免疫检查点抑制剂（ICI）可导致内分泌不良事件。然而，内分泌不良事件（AEs）。然而，内分泌AEs可能与更好的治疗结果相关。我们的目的是调查在转移性黑色素瘤患者的真实世界环境中是否确实如此。
一项回顾性单机构研究。
我们纳入了2012年1月至2019年5月期间连续接受ICI治疗的140例转移性黑色素瘤患者。我们从电子病历中评估内分泌毒性和最佳可能的治疗结果，包括实验室参数和放射影像。
在接受治疗的患者中，21例（15%）接受了伊匹单抗治疗，46例（33%）接受了纳武单抗治疗，67例（48%）接受了派姆单抗治疗，6例（4%）接受了联合治疗（伊匹单抗+纳武单抗）。29%（41/140）的患者出现内分泌AEs。3例患者有两种不同的内分泌AEs。甲状腺疾病最为常见：26%（36/140），其次是垂体炎：4%（5/140）。3名受试者（2%，3/140）被诊断为自身免疫性糖尿病。3例患者因内分泌毒性不得不终止治疗。16例患者（39%，16/41）发现内分泌AEs的放射学表现。内分泌毒性与明显更好的治疗结果相关。发生内分泌AEs的患者的无进展生存期（8.1个月，范围5.1 - 11.1个月 vs 2.7个月，范围2.4 - 3.0个月，P < 0.001）及总生存期（47.5个月，范围15.5 - 79.5个月 vs 23.7个月，范围15.3 - 32.1个月，P = 0.035）更长。
内分泌AEs数量较多表明定期实验室监测有助于不良事件的检测。转移性黑色素瘤中的内分泌AEs可能与更好的治疗结果相关。
