Wang Yanling, Ma Xiaoping, Ma Jia, Li Jing, Lin Zhiyi, Gao Wei, Gong Ping, Dai Ping
Department of Oncology, The First Affiliated Hospital of School of Medicine Shihezi University, Shihezi, Xinjiang, 832000, People's Republic of China.
Department of General Surgery, Shanghai Jian Gong Hospital, Shanghai, 200083, People's Republic of China.
BMC Cancer. 2025 Apr 28;25(1):791. doi: 10.1186/s12885-025-14097-w.
To investigate the correlation between thyroid dysfunction (TD) and the efficacy of programmed cell death protein 1 (PD-1) and programmed death ligand 1 (PD-L1) inhibitors in the treatment of advanced lung cancer, and the possible influencing factors for TD occurrence, providing insights that could guide individualized therapeutic approaches.
The data of 120 advanced lung cancer patients from January 2019 to August 2024 were retrospectively collected. Then, the patients were divided into TD and non-TD subgroups according to whether TD occurred or not, to analyse the possible factors influencing the occurrence of TD and the correlation between TD and PD-1/PD-L1 inhibitor efficacy.
For all cases, the baseline TSH level was significantly higher in the TD subgroup than in the non-TD subgroup (median: 2.33 mIU/L vs. 1.58 mIU/L, p = 0.001). The progression-free survival (PFS) was significantly longer in the TD subgroup than in the non-TD subgroup (mPFS: 7.90 months vs. 4.87 months, p = 0.003), and the patients in the TD subgroup had a lower HR for progression (0.499, 95% CI (0.317-0.766)). For the PD-1/PD-L1 inhibitor group, the baseline TSH level was also significantly higher in the TD subgroup than in the non-TD subgroup (median: 2.16 mIU/L vs. 1.52 mIU/L, p = 0.009). The PFS was also significantly longer in the TD subgroup than in the non-TD subgroup (mPFS: 8.83 months vs. 6.50 months, p = 0.041).
The baseline TSH level was the predictive factor for the occurrence of TD. The occurrence of TD was positively associated with a favorable prognosis for patients with advanced lung cancer.
探讨甲状腺功能障碍（TD）与程序性细胞死亡蛋白1（PD-1）和程序性死亡配体1（PD-L1）抑制剂治疗晚期肺癌疗效之间的相关性，以及TD发生的可能影响因素，为指导个体化治疗方案提供依据。
回顾性收集2019年1月至2024年8月120例晚期肺癌患者的数据。然后，根据是否发生TD将患者分为TD亚组和非TD亚组，分析影响TD发生的可能因素以及TD与PD-1/PD-L1抑制剂疗效之间的相关性。
所有病例中，TD亚组的基线促甲状腺激素（TSH）水平显著高于非TD亚组（中位数：2.33 mIU/L对1.58 mIU/L，p = 0.001）。TD亚组的无进展生存期（PFS）显著长于非TD亚组（中位PFS：7.90个月对4.87个月，p = 0.003），且TD亚组患者的疾病进展风险比（HR）较低（0.499，95%置信区间（0.317 - 0.766））。对于PD-1/PD-L1抑制剂组，TD亚组的基线TSH水平同样显著高于非TD亚组（中位数：2.16 mIU/L对1.52 mIU/L，p = 0.009）。TD亚组的PFS也显著长于非TD亚组（中位PFS：8.83个月对6.50个月，p = 0.041）。
基线TSH水平是TD发生的预测因素。TD的发生与晚期肺癌患者的良好预后呈正相关。
