Nivolumab-induced thyroid dysfunction lacking antithyroid antibody is frequently evoked in Japanese patients with malignant melanoma

• Published in: BMC endocrine disorders 2018-06, Vol.18 (1), p.36-36, Article 36
• Main Authors: Yano, Seiichi, Ashida, Kenji, Nagata, Hiromi, Ohe, Kenji, Wada, Naoko, Takeichi, Yukina, Hanada, Yuki, Ibayashi, Yuta, Wang, Lixiang, Sakamoto, Shohei, Sakamoto, Ryuichi, Uchi, Hiroshi, Shiratsuchi, Motoaki, Furue, Masutaka, Nomura, Masatoshi, Ogawa, Yoshihiro
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Aged; Aged, 80 and over; Antibodies, Monoclonal - adverse effects; Antibodies, Monoclonal - therapeutic use; Antigens; Apoptosis; Cell death; Complications and side effects; Cytotoxicity; Demographic aspects; Dosage and administration; Drug therapy; Female; Humans; Hyperthyroidism; Hypothyroidism; Immunoglobulins; Immunotherapy; Japan - epidemiology; Lymphocytes; Male; Melanoma; Melanoma - complications; Melanoma - drug therapy; Metastasis; Middle Aged; Monoclonal antibodies; Nivolumab; Patients; PD-1 protein; Peroxidase; Prognosis; Programmed cell death − 1; Retrospective Studies; Risk factors; Skin cancer; Targeted cancer therapy; Thyroid; Thyroid diseases; Thyroid Diseases - chemically induced; Thyroid Diseases - complications; Thyroid Diseases - diagnosis; Thyroiditis; Thyrotoxicosis; Thyroxine
• ISSN: 1472-6823; 1472-6823
• DOI: 10.1186/s12902-018-0267-x

Nivolumab, an anti-programmed cell death-1 monoclonal antibody, has improved the survival of patients with malignant melanoma. Despite its efficacy, nivolumab inconsistently induces thyroid dysfunction as an immune-related adverse event (irAE). This study aimed to evaluate nivolumab-induced thyroid dysfunction to determine the risks and mechanisms of thyroid irAEs. After excluding 10 patients, data of 24 patients with malignant melanoma (aged 17-85 years; 54% female) were retrospectively analyzed. Thyroid irAEs were observed in seven patients (29%). Three patients had hypothyroidism after preceding transient thyrotoxicosis, and the other four patients had hypothyroidism without thyrotoxicosis. Levothyroxine-Na replacement was required in three patients. Antithyroid antibody (ATA) titer was elevated in one of four assessable patients. The average (±SD) time to onset of thyroid irAE was 33.6 (±21.9) weeks. The administration period of nivolumab was longer in patients with thyroid irAEs than in those without thyroid irAEs (P