Thyroid dysfunction associated with immunotherapy for patients with cancer.
The authors performed a prospective study to evaluate thyroid dysfunction in 130 patients with cancer who were receiving interleukin-2 (IL-2)-based immunotherapy. Primary hypothyroidism was the most common abnormality, occurring in 12% of patients before, 38% during, and 23% after immunotherapy. Hyperthyroidism occurred in 1%, 4%, and 7% of patients at those time intervals. Among patients initially euthyroid (n = 111), primary hypothyroidism developed in 32% during and 14% after immunotherapy, persisting a median of 54 days. Three patients required levothyroxine. Hyperthyroidism developed in 2% of patients during immunotherapy and 6% after. Thyroid dysfunction was not a function of sex, diagnosis, type of treatment, or response to immunotherapy. Elevated titers of antithyroglobulin and antithyroid microsomal antibodies were detected after treatment in 9% and 7%, respectively, of all patients without prior antibody abnormalities and did not correlate with response to therapy. The high incidence of therapy-induced thyroid dysfunction suggests that thyroid function should be carefully monitored in all patients receiving IL-2-based immunotherapy.
Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892.
D J
DJ
Schwartzentruber
D E
DE
White
M H
MH
Zweig
B D
BD
Weintraub
S A
SA
Rosenberg
D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D002648:Child; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications / Q000209:etiology; D007167:Immunotherapy / Q000009:adverse effects* / Q000379:methods; D007376:Interleukin-2 / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D011446:Prospective Studies; D013959:Thyroid Diseases / Q000209:etiology* / Q000276:immunology
D001323:Autoantibodies; D007376:Interleukin-2; C006606:anti-thyroglobulin; C056626:thyroid microsomal antibodies