ArticleEndocrine connections2026
Association of basal thyroid function with clinical outcomes in patients with recurrent or metastatic nasopharyngeal carcinoma treated with PD-L1 inhibitor KL-A167: a multicenter post hoc analysis.
Article in Endocrine connections, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: While thyroid dysfunction during PD-L1 inhibitor therapy correlates with efficacy in recurrent/metastatic nasopharyngeal carcinoma, the prognostic value of basal thyroid function remains unclear. This study investigated the relationship between baseline serum thyroid-stimulating hormone (TSH) and clinical outcomes. Methods: We conducted a multicenter, retrospective analysis of 153 recurrent/metastatic nasopharyngeal carcinoma (R/M NPC) patients from a prospective phase 2 trial of the PD-L1 inhibitor KL-A167. Patients were stratified by baseline TSH levels. Multivariate Cox and logistic regression models were used to analyze progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). Results: High basal TSH (n = 58) was independently associated with significantly prolonged OS (HR 0.56, 95% CI: 0.36-0.88; P = 0.011) and PFS (HR 0.60, 95% CI: 0.41-0.87; P = 0.008) compared to the low/normal TSH group (n = 95). Although ORR was numerically higher in the high TSH group (27.6 vs 17.9%), the difference was not statistically significant (P = 0.23). Subgroup analyses indicated consistent benefits across most clinical strata. Thyroid immune-related adverse events occurred in 32/153 (20.9%), similarly between groups (20.7 vs 21.1%, P = 0.957), and were not significantly associated with either OS (HR 0.65, 95% CI: 0.38-1.11, P = 0.117) or PFS (HR 0.88, 95% CI: 0.54-1.44, P = 0.613) by time-varying Cox regression. Conclusion: Elevated basal TSH levels are independently associated with improved survival in R/M NPC patients receiving KL-A167. Baseline TSH may serve as a simple, noninvasive biomarker for risk stratification and personalizing immunotherapy in this population.
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