Morphological changes of the thyroid gland as a new radiographic marker for lung cancer treatment efficacy of immune checkpoint inhibitors

• Published in: Acta radiologica (1987) Vol. 62; no. 1; p. 42
• Main Authors: Itonaga, Tomohiro, Saito, Kazuhiro, Ikeda, Norihiko, Mikami, Ryuji
• Format: Journal Article
• Language: English
• Published: England 01.01.2021
• Subjects: Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - immunology; Female; Humans; Immune Checkpoint Inhibitors - therapeutic use; Lung Neoplasms - drug therapy; Lung Neoplasms - immunology; Male; Middle Aged; Thyroid Gland - diagnostic imaging; Thyroid Gland - immunology; Tomography, X-Ray Computed - methods; Treatment Outcome; Non-small-cell lung cancer; thyroid; PD-1; radiographic marker
• ISSN: 1600-0455
• DOI: 10.1177/0284185120916197

Fully human IgG4 programmed cell death-1 (PD-1) immune checkpoint inhibitors are effective against non-small-cell lung cancer (NSCLC). PD-1-targeted antibodies induce autoimmune adverse events that are not caused by conventional chemotherapy. To clarify the association between morphological changes of the thyroid gland and the efficacy of PD-1 immune checkpoint inhibitor treatment for lung cancer. The study enrolled 29 patients who received PD-1 immune checkpoint inhibitor treatment. The thyroid volume was measured using computed tomography (CT) at the following three timepoints: pre-treatment (baseline); three months after the initial administration (early treatment); and at the last CT scan during the observation period (late treatment). Thyroid volume ratios were calculated as follows: early treatment/baseline thyroid volume at CT (E/B-CT ratio) and late treatment/baseline thyroid volume at CT (L/B-CT ratio). Thyroid dysfunction was assessed according to thyroid hormone levels. The E/B-CT ratio was significantly higher in patients with adverse events of grade 3 or higher than in the other patients (  = 0.013). The L/B-CT ratio was significantly lower in patients with thyroid dysfunction than in those without thyroid dysfunction (  = 0.001). Complete response (CR) was achieved in three patients at the time of the final CT. The E/B-CT ratio was significantly higher in patients with CR than in the other patients (1.48 vs. 0.99,  = 0.029). Changes in thyroid volume after administration of PD-1 immune checkpoint inhibitors might be a useful radiographic marker of therapeutic efficacy in patients with lung cancer.