Thyroid dysfunction induced by immune checkpoint inhibitors and tumor progression during neoadjuvant therapy of non‑small cell lung cancer: A case report and literature review

Abstract

Immune checkpoint inhibitors (ICIs) have a demonstrable treatment response in patients with resectable non-small cell lung cancer (NSCLC). However, immune-related adverse events and tumor progression in patients administered ICIs are of great concern. The present case study is of a 59-year-old male with NSCLC (squamous, stage IIIA) who received neoadjuvant immunotherapy combined with chemotherapy before surgery. The patient first developed hyperthyroidism and then hypothyroidism, indicating that ICI-related thyroid dysfunction had occurred. Furthermore, the patient suffered from tumor progression and could not undergo resection. The present case called attention to the prevention and management of irAEs, and the precaution that should be taken with regard to tumor progression. The case also suggested that the development of ICI-related thyroid dysfunction may not predict an improved response to ICI therapies, which needs further evidence to illustrate.

Thyroid disorders induced by immune checkpoint inhibitors

“…In contrast to these findings, a case study highlighted a lung cancer patient who developed ICI-related thyroid dysfunction, leading to tumor progression and preventing surgical intervention. This suggests that thyroid dysfunction does not uniformly indicate a better response to ICI treatments [ 43 , 46 ]. This becomes more intricate as studies propose that thyrotoxicosis could potentially exacerbate cancer prognosis [ 47 ].…”