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Vol.57 No.4 contents | Japanese/English |
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- Case Report -
Two Patients with Non-small Cell Lung Cancer Developed Thyroid Dysfunction Accompanied by the Emergence of Anti-thyroglobulin Antibodies During Nivolumab Therapy
Misuzu Yoshihara1, Ryosuke Kimura2, Eiji Kunii1, Yuta Mori1, Minoru Horiuchi1, Kenji Akita11Depatment of Respiratory Medicine, Respiratory Tract Oncology Center, 2Department of Endocrinology and Metabolism, Nagoya City West Medical Center, Japan
Background. Although nivolumab is applied as standard second-line chemotherapy for non-small cell lung cancer (NSCLC), it induces many immune-related adverse events (irAEs), including thyroid dysfunction. The various clinical features and pathogenesis of thyroid dysfunction induced by nivolumab are not well defined. Case 1. A 47-year-old man diagnosed with cT1bN2M1b stage IV lung adenocarcinoma underwent surgical resection of brain metastasis followed by several lines of chemotherapy. Nivolumab was initiated as the third line chemotherapy. Case 2. A 66-year-old man relapsed after undergoing surgical resection of cT1bN0M0 stage IB squamous cell carcinoma of the lung. Several lines of chemotherapy were administered; nivolumab was initiated as the fourth line. In both cases, a blood test after the initiation of nivolumab revealed increased levels of free triiodothyronine (FT3), free thyroxine (FT4), and anti-thyroglobulin antibody (TgAb), and decreased levels of thyroid-stimulating hormone (TSH). The clinical findings were consistent with those of silent thyroiditis. Nivolumab therapy was continued and the regression of the tumors was remarkable. Conclusion. Silent thyroiditis is one of clinical features of thyroid dysfunction when only TgAb emerges among the thyroid auto-antibodies induced during nivolumab therapy. Thus, it is recommended that thyroid function test be performed at regular intervals in order to detect the induction of thyroid dysfunction by nivolumab therapy at an early stage.
key words: Nivolumab, Non-small cell lung cancer, Thyroid dysfunction, Anti-thyroglobulin antibody, Silent thyroiditis
Received: March 16, 2017
Accepted: April 24, 2017
JJLC 57 (4): 308-314, 2017
