Meta-analysis of the predictive value of baseline thyroid antibody for thyroid adverse events following immune checkpoint inhibitor treatment in malignant tumors
10.3760/cma.j.cn311282-20240422-00160
- VernacularTitle:基线甲状腺抗体对恶性肿瘤免疫检查点抑制剂治疗后出现甲状腺不良事件预测价值的 meta分析
- Author:
Hui MING
1
;
Hui YU
;
Qiang ZHOU
;
Yuanhao CHEN
Author Information
1. 黄石市中心医院（湖北理工学院附属医院）核医学科 435000
- Keywords:
Immune-checkpoint inhibitor;
Programmed cell death protein 1;
Programmed cell death 1 ligand 1;
Cytotoxic T lymphocyte-associated antigen-4;
Thyroid antib
- From:
Chinese Journal of Endocrinology and Metabolism
2024;40(10):851-857
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the predictive value of baseline thyroid antibodies for thyroid adverse events following treatment with immune checkpoint inhibitors (ICIs) in malignant tumors using meta-analysis. Methods:Studies on the thyroid related adverse reactions following immune checkpoint inhibitor therapy for malignant tumors in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang databases were searched. Literature was screened based on inclusion and exclusion criteria, study data were extracted, and meta-analysis was conducted using the RevMan 5.4 and Stata 12.0. Results:A total of 10 articles on ICIs therapy for malignant tumors were included, encompassing 1 480 patients, of whom 251 had positive baseline thyroid antibodies (TPOAb or TgAb). After ICIs therapy, 270 cases developed thyroid immune related adverse events (irAEs). Meta analysis showed that positive baseline thyroid antibodies predicted thyroid irAEs, with a pooled sensitivity of 0.45 (95% CI 0.35-0.56), pooled specificity of 0.95 (95% CI 0.91-0.98), pooled positive likelihood ratio of 4.04 (95% CI 3.01-5.42), pooled negative likelihood ratio of 0.57 (95% CI 0.48-0.68), and pooled diagnostic odds ratio of 16.31 (95% CI 9.76-27.24). The area under the summary receiver operating characteristics was 0.80 (95% CI 0.76-0.83). Meta regression showed that differences in regions and tumor types led to heterogeneity. Conclusion:Baseline thyroid antibodies (TPOAb and TgAb) have high predictive performance and specificity for thyroid irAEs after ICIs treatment of malignant tumors. This facilitates early prediction of thyroid irAEs, reduces the risk of adverse outcomes due to undiagnosed thyroid dysfunction, and holds important clinical value.
