Wu Yanfei, Wang Zhi, Bai Hongxia, Gao Yan
Department of Pathology, Navy Medical Center of People Liberation Army, Naval Medical University, Shanghai 200433, P.R. China.
Department of Nuclear Radiation Injury Protection and Treatment, Navy Medical Center of People Liberation Army, Naval Medical University, Shanghai 200433, P.R. China.
Oncol Lett. 2022 Jul 13;24(3):309. doi: 10.3892/ol.2022.13429. eCollection 2022 Sep.
The use of programmed cell death-1 (PD-1) inhibitors has recently been approved in China. As a consequence, the identification of relevant prognostic markers that can assess the efficacy of these compounds is required. Therefore, the present study aimed to explore the incidence of thyroid dysfunction and its ability to predict progression-free survival (PFS) in Chinese patients with cancer who received PD-1 inhibitor treatment. Data from 72 patients with cancer who received treatment with PD-1 inhibitors alone or in combination with chemotherapy or targeted drugs were analyzed. Moreover, the expression levels of free triiodothyronine, thyroxine, and thyrotropin during treatment were assessed to evaluate thyroid dysfunction. A total of 26 (36.1%) patients who had received PD-1 inhibitors developed thyroid dysfunction. Specifically, the incidence of thyroid dysfunction was 35.6% in patients with lung cancer, 25.0% in patients with malignant melanoma, and 46.7% in patients with other types of cancer. In addition, the median PFS was 7.0 (95% confidence interval, 4.9-9.1) months, whereas the 1- and 2-year PFS rates were 35.1 and 26.2%, respectively. Generally, patients with thyroid dysfunction exhibited longer PFS compared with those without thyroid dysfunction (P=0.001). Subgroup analyses were subsequently performed, which demonstrated that thyroid dysfunction was associated with longer PFS in patients with malignant melanoma (P=0.039) and other types of cancer (P=0.002), but not in those with lung cancer (P=0.083). These findings were noted in patients who received PD-1 inhibitor monotherapy (P=0.003), but not PD-1 inhibitor plus chemotherapy (P=0.172) or PD-1 inhibitor plus targeted therapy (P=0.582). Finally, thyroid dysfunction [P=0.001; hazard ratio (HR)=0.260] and PD-1 inhibitor monotherapy (P=0.015; HR=2.231) were identified as independent factors that could predict PFS. In conclusion, the present study demonstrated that thyroid dysfunction during PD-1 inhibitor treatment could be used as a potential marker for the prognosis of favorable PFS in patients with cancer.
程序性细胞死亡蛋白1（PD-1）抑制剂的使用最近在中国获得批准。因此，需要鉴定能够评估这些化合物疗效的相关预后标志物。因此，本研究旨在探讨接受PD-1抑制剂治疗的中国癌症患者甲状腺功能障碍的发生率及其预测无进展生存期（PFS）的能力。分析了72例单独接受PD-1抑制剂治疗或联合化疗或靶向药物治疗的癌症患者的数据。此外，评估治疗期间游离三碘甲状腺原氨酸、甲状腺素和促甲状腺激素的表达水平，以评估甲状腺功能障碍。共有26例（36.1%）接受PD-1抑制剂治疗的患者出现甲状腺功能障碍。具体而言，肺癌患者甲状腺功能障碍的发生率为35.6%，恶性黑色素瘤患者为25.0%，其他类型癌症患者为46.7%。此外，中位PFS为7.0（95%置信区间，4.9-9.1）个月，而1年和2年PFS率分别为35.1%和26.2%。一般来说，与无甲状腺功能障碍的患者相比，有甲状腺功能障碍的患者PFS更长（P=0.001）。随后进行了亚组分析，结果表明，甲状腺功能障碍与恶性黑色素瘤患者（P=0.039）和其他类型癌症患者（P=0.002）的PFS延长相关，但与肺癌患者无关（P=0.083）。这些发现见于接受PD-1抑制剂单药治疗的患者（P=0.003），但在接受PD-1抑制剂联合化疗（P=0.172）或PD-1抑制剂联合靶向治疗的患者中未观察到（P=0.582）。最后，甲状腺功能障碍[P=0.001；风险比（HR）=0.260]和PD-1抑制剂单药治疗（P=0.015；HR=2.231）被确定为可预测PFS的独立因素。总之，本研究表明，PD-1抑制剂治疗期间的甲状腺功能障碍可作为癌症患者PFS良好预后的潜在标志物。
