The following article features coverage from the American Thyroid Association (ATA) 2018 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Thyroid immune-related adverse events (irAEs) are common among patients treated with anti–PD-L1 antibodies, according to a retrospective study presented at the 88th Annual Meeting of the American Thyroid Association in Washington, D.C.1

PD-L1 inhibitors are associated with an increased risk of developing irAEs. The purpose of this study was to characterize thyroid irAEs to improve detection and management strategies.

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The retrospective cohort study included 91 patients who received an anti–PD-L1 inhibitor between 2016 and 2018 at the Mayo Clinic. The median age of the cohort was 68, 52% were male, and the median follow-up was 5 months.

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irAEs developed in 46% of patients, of which, 25% were related to the thyroid. Thyroid irAEs included acute thyroiditis (22%), new-onset hypothyroidism (61%), and worsening hypothyroidism (17%). Thyroid irAEs developed after 2 doses of the PD-L1 inhibitor, with a median time to development of 1.4 months.

Patients were managed by observation (52%) or through treatment with  levothyroxine (48%).

At baseline, elevated levels of thyroperoxidase (TPO) antibodies was present in 31% of patients, with 2 patients developing a thyroid irAE. Most patients who developed a thyroid irAE demonstrated a diffusely elevated FDG thyroid uptake on PET (P = .001).

Patients who developed a thyroid irAE had an overall survival of 12 months compared with 9.9 months among patients who did not experience a thyroid irAE (P = .03). The authors note, however, that additional studies are needed to determine if a thyroid irAE is a marker of antitumor response.

The authors concluded that thyroiditis is the most common endocrine irAE associated with PD-L1 inhibition. They stated that “diffuse thyroid uptake on FDG-PET [fluorodeoxyglucose-positron emission tomography] scan, but not elevated TPO antibodies, appears to identify patients at risk for thyroiditis/hypothyroidism.”

Read more of Cancer Therapy Advisor‘s coverage of the ATA 2018 meeting by visiting the conference page.


  1. Kotwal A, Kottschade L, Ryder M. Programmed cell death protein ligand-1 inhibitor-associated thyroiditis: a retrospective comprehensive review at Mayo Clinic. Presented at: the 88th Annual Meeting of the American Thyroid Association; Washington, D.C.: October 3-7, 2018. Abstract clinical oral 12.