Endocrine immune-related adverse events in advanced lung cancer patients receiving immune checkpoint inhibitors: incidence, predictors and outcomes

作者：Yi Liu, Jiarui Zhang, Linhui Yang, Jiadi Gan, Huohuo Zhang, Qi Qi, Wanqin Fang, J B Zhu, Rui Xu, Xianya Hu, Yufang Xie, Sha Liu, Weimin Li, Dan Liu · 发表于：Translational Lung Cancer Research · 年份：2025 · DOI：10.21037/tlcr-2025-1064 · 被引用次数：2 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Research Studies、Cancer, Stress, Anesthesia, and Immune Response

Background: Immune checkpoint inhibitors (ICIs) have markedly improved outcomes in lung cancer but may lead to immune-related adverse events (irAEs). Among them, endocrine irAEs (e-irAEs) are frequent, yet their risk factors and prognostic implications remain unclear. This study aimed to investigate the incidence, predictors, and clinical outcomes of e-irAEs in patients with advanced lung cancer receiving ICIs. Methods: In this single-center retrospective cohort study, we analyzed patients with advanced lung cancer who received at least 2 cycles of ICIs from January 2019 to October 2023 at West China Hospital of Sichuan University. Patients were categorized into e-irAE and no e-irAE groups. The cumulative incidence of e-irAE was estimated using the Aalen-Johansen method, accounting for death as a competing risk. Risk factors for e-irAEs were assessed using Fine-Gray subdistribution hazard model and logistic regression, while a time-dependent Cox model was employed to evaluate the impact of e-irAEs on progression-free survival (PFS) and overall survival (OS). Results: Our analysis included 603 patients in total, 60 (10.0%) developed e-irAEs, predominantly hypothyroidism (73.3%) and thyrotoxicosis (23.3%), with a median onset of 4.0 months. During follow-up, 261 (43.3%) patients died. Female sex [subdistribution hazard ratio (SHR), 2.27; 95% confidence interval (CI), 1.23–4.21; P=0.009], lung metastasis (SHR, 1.79; 95% CI, 1.07–3.02; P=0.03), elevated thyroid stimulating hormon...