Evidence map›Paper›PMID 39695571›Full record

Observational studyBMC medicine2024

The burden and clinical trajectory of immune checkpoint inhibitor-induced endocrinopathies: an 8-year experience.

Fateen Ata, Adeel Ahmad Khan, Emad Algorani, Amr Faisal Musaed Alsharafi, Reham Abo Shdid, Mohammad Nofal, Ayman R Ibrahim, Loai Abdullah, Khalil Youssef El Annan, Tareq Emad Hawash Al-Bkoor and 3 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Fateen AtaDepartment of Endocrinology, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar. docfateenata@gmail.com.ORCID 0000-0001-7121-8574
Adeel Ahmad KhanDepartment of Endocrinology, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.
Emad AlgoraniDepartment of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Amr Faisal Musaed AlsharafiDepartment of Family Medicine, Hamad Medical Corporation, Doha, Qatar.
Reham Abo ShdidDepartment of Geriatric Medicine, Hamad Medical Corporation, Doha, Qatar.
Mohammad NofalDepartment of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Ayman R IbrahimDepartment of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Loai AbdullahDepartment of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Khalil Youssef El AnnanDepartment of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Tareq Emad Hawash Al-BkoorDepartment of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Kakil Ibrahim RasulDepartment of Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.
Tarik ElhaddDepartment of Endocrinology, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.
Haval SurchiDepartment of Endocrinology, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmune checkpoint inhibitors (ICIs) have revolutionized the management of cancer patients, but the emergence of ICI-related endocrinopathies (IREs) has introduced new clinical challenges. Despite worldwide recognition of these adverse effects, data from the Middle East is scarce.

methodsThis retrospective-observational study included adult cancer patients who received at least one dose of ICI between January 2015 and January 2023. Descriptive statistics and multivariable regression (MVR) models were applied to delineate the incidence and clinical impact of IREs.

resultsThe median age of 649 included patients was 55 years, with male preponderance (70.7%). The incidence of IREs was 26.7%, dominated by primary hypothyroidism (62.4%), insulin deficiency (15%), and primary hyperthyroidism (13.9%). Pembrolizumab (62%) was the most utilized ICI among the study cohort, followed by nivolumab (23.7%), atezolizumab (12.5%), durvalumab (0.9%), avelumab (0.6%) and ipilimumab (0.1%). The mortality rates in the cohort and the IRE subgroup were 43.4% and 42.2%. MVR revealed age (OR 1.02, 95% CI (1.003-1.03), P = 0.02), pre-ICI white-cell (WBC) count (OR 0.94, 95% CI (0.89-0.99), P = 0.04), pembrolizumab (OR 2.6, 95% CI (1.05-6.3), P = 0.04), and nivolumab use (OR 2.6, 95% CI (1.04-6.6), P = 0.04) as significant predictors of IREs. After MVR, factors influencing mortality in the subgroup with IREs included a higher age (OR 1.1, 95% CI 1.04-1.2, P = 0.001) and platelet-to-lymphocyte ratio (OR 1.004, 95% CI 0.7-1.4, P = 0.006).

conclusionsThis first extensive Middle Eastern and South Asian cohort reported a higher-than-previously known incidence of IREs. Hypothyroidism, insulin deficiency, and hyperthyroidism were the commonest IREs, with pembrolizumab being the commonest ICI. IRE development was associated with higher age, a low WBC count, pembrolizumab, and nivolumab use. The development of IREs did not seem to influence mortality. Further research on IREs is imperative to optimize management guidelines in the era of precision medicine.

Indexed as

Endocrine System DiseasesImmune Checkpoint InhibitorsAdultAgedFemaleHumansIncidenceMaleMiddle AgedNeoplasmsRetrospective StudiesImmune Checkpoint InhibitorsAtezolizumabAvelumabDurvalumabEndocrinopathiesImmune checkpoint inhibitorsIpilimumabNivolumabPembrolizumab

Identifiers

PMID39695571
PMCPMC11656579

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.