# Thyroid and cortisol endocrinopathies and survival in cancer patients treated with immune checkpoint inhibitors in UAE

## TL;DR

This study found that thyroid and cortisol-related side effects in cancer patients treated with immune checkpoint inhibitors are linked to better survival rates.

## Contribution

The novel contribution is identifying a favorable survival trend associated with thyroid and cortisol endocrinopathies in ICI-treated cancer patients.

## Key findings

- Thyroid-related events were all post-thyroiditis hypothyroidism, and cortisol-related events were ACTH deficiency.
- Patients with endocrinopathies showed improved overall survival compared to those without.
- Endocrinopathies occurred most frequently in patients treated with anti–PD-1 agents.

## Abstract

Immune checkpoint inhibitors (ICIs) are associated with immune-related adverse events (irAEs) of which endocrinopathies are among the most frequent. This study aimed to identify thyroid and cortisol-related endocrine-related adverse events (ERAEs) in a cohort of patients treated with ICIs and to examine survival differences between patients who developed endocrinopathies and those who did not.

We conducted a retrospective review of electronic medical records of adult patients who received ICIs between 2018 and 2023. Data were collected specifically on thyroid and cortisol-related ERAEs.

Among 616 patients, 59 (9.6%) developed thyroid or cortisol-related ERAEs. The mean time to onset was 22.7 weeks. All thyroid-related events were post-thyroiditis hypothyroidism (n = 55), while all cortisol-related events were due to adrenocorticotropic hormone (ACTH) deficiency (n = 11). The majority of these events occurred in patients treated with anti–PD-1 agents, the most commonly used therapy in this cohort. Patients who developed ERAEs demonstrated improved overall survival during the follow-up period compared to those without endocrine toxicity.

In this cohort, systematic monitoring identified thyroid- and cortisol-related ERAEs in 9.6% of patients, consisting exclusively of post-thyroiditis hypothyroidism and ACTH deficiency. The occurrence of these endocrinopathies was associated with a favorable survival trend, underscoring the importance of early recognition and management of endocrine irAEs in patients receiving ICIs.