Immune-related Endocrine Dysfunction in Chinese: a single tertiary centre experience

Abstract

Background: Cancer immunotherapy, particularly treatment with immune checkpoint inhibitors, has become an important treatment of many cancer types. Use of immune checkpoint inhibitors is often associated with immune-related adverse events (irAEs). Endocrine dysfunction is one of the common irAEs. Majority of the studies on immune-related endocrine dysfunction (irED) were conducted in Western countries and there is few Asian patients data. This study aims to review the frequency and nature of irED in Chinese. Methods: A retrospective review of all Chinese patients treated for cancer with antiPD1/ anti-PDL1 or anti-CTLA4 or combination therapy (with chemotherapy or targeted agent) in Department of Clinical Oncology, Queen Mary Hospital, from January 2014 to December 2019 was performed. Demographic data, cancer type and stage, drug treatment, details about irEDs were extracted. Results: Total 953 patients (male: 603, 64%; median age: 62.0 years) received immune checkpoint inhibitors during the study period. 570 patients (59.8%) used monoimmunotherapy, 133 (14.0%) used dual-immunotherapy, 206 (21.6%) used immunotherapy with chemotherapy and 78 (8.2%) used immunotherapy with targeted agent. 168 patients (17.63%) had hypothyroidism with median onset time 9.9+/-17.5 weeks. 71 patients (11.8%) had hyperthyroidism with median onset time 8.1+/-25.3 weeks. 82 patients (8.6%) had hypocortisolism with median onset time 21.2+/-26.6 weeks. 69 patients (7.2%) had hypercortisolium with median onset time 9.6+/-33.1 weeks.