BACKGROUND Nivolumab, a fully human IgG4 programmed cell death-1 checkpoint inhibitor, demonstrated its benefit of prolonged survival in advanced non-small cell lung cancer (NSCLC). However, nivolumab generated unique immune-related adverse events such as thyroid dysfunctions. Herein we assessed nivolumab-induced thyroid dysfunctions in patients with previously treated advanced NSCLC in our hospital. METHODS The medical records of 11 patients with advanced NSCLC who were initiated with nivolumab treatment between June 28, 2018, and January 15, 2019, in our hospital were reviewed. Serological tests of thyroid-stimulating hormone and free tetraiodothyronine were measured at baseline and every 8 weeks. RESULTS Three out of 11 patients developed new-onset hypothyroidism during the treatment, and two of three patients had transient hyperthyroidism first. Two patients were diagnosed with Grade 2 hypothyroidism and received levothyroxine therapy. The other one was Grade 1 hypothyroidism and asymptomatic. All these three patients continued nivolumab therapy. CONCLUSION Nivolumab-induced thyroid dysfunctions in advanced NSCLC were mostly mild and controlled. Thyroid function needs to be monitored for early prediction and appropriate managements of thyroid dysfunctions.

中文翻译：

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以前接受过治疗的非小细胞肺癌患者中Nivolumab诱导的甲状腺功能异常。

背景：Nivolumab是一种完全由人IgG4程序控制的细胞死亡1检查点抑制剂，显示出其在晚期非小细胞肺癌（NSCLC）中延长生存期的益处。但是，nivolumab会产生独特的免疫相关不良事件，例如甲状腺功能障碍。在此，我们评估了在我院接受过先前治疗的晚期非小细胞肺癌患者的纳武单抗诱发的甲状腺功能障碍。方法回顾性分析我院2018年6月28日至2019年1月15日开始接受nivolumab治疗的11例晚期NSCLC患者的病历。在基线和每8周测量一次促甲状腺激素和游离四碘甲甲状腺素的血清学测试。结果11例患者中有3例在治疗期间出现了新发甲状腺功能减退症，三分之二的患者先有短暂甲状腺功能亢进。两名患者被诊断为2级甲状腺功能减退症并接受了左甲状腺素治疗。另一个是1级甲状腺功能减退症和无症状。这三名患者均继续接受尼古鲁单抗治疗。结论Nivolumab引起的晚期非小细胞肺癌的甲状腺功能异常多数为轻度且可控。需要对甲状腺功能进行监测，以进行早期预测并适当处理甲状腺功能障碍。