{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:06:00Z","timestamp":1789103160178,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Immune checkpoint inhibitors (ICIs) frequently cause thyroid immune\u2010related adverse events (irAEs). Permanent hypothyroidism, the clinically most relevant phenotype, requires lifelong hormone replacement. We investigated its incidence, course, risk factors, and prognostic relevance under pembrolizumab. This retrospective single\u2010center study included patients from the Departments of Gynecology and Dermatology who received \u2265\u20093\u2009cycles of pembrolizumab between 2018 and 2024. Permanent hypothyroidism occurred in 30\/188 patients (16.0%). Thyrotoxicosis was observed in 46\/188 (24.5%) and de novo hypothyroidism in 33\/188 (17.6%). Overt thyrotoxicosis progressed to permanent hypothyroidism in 71% of cases. Nearly all permanent cases were overt at first detection (29\/30), and most patients were asymptomatic. Permanent hypothyroidism developed earlier than transient courses (median 15 vs. 26\u2009weeks), and no new permanent events occurred beyond 50\u2009weeks. Prior chemotherapy was strongly associated with permanent hypothyroidism (33% vs. 11%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001), whereas age, sex, tumor stage, treatment setting, and other systemic therapies were not. Permanent hypothyroidism was not associated with progression\u2010free survival, recurrence\u2010free survival, or overall survival. Permanent hypothyroidism is a common pembrolizumab\u2010related irAE, typically occurring within the first 6\u2009months but occasionally up to 12\u2009months after treatment initiation. Prior chemotherapy emerged as an independent predictor of permanent hypothyroidism. Most cases were mild and manageable with oral levothyroxine. These findings suggest that cycle\u2010based thyroid monitoring may warrant continuation through the first 12\u2009months of ICI therapy, with heightened attention to patients with prior chemotherapy exposure.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70735","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:11:29Z","timestamp":1789099889000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and Predictors of Immune\u2010Related Hypothyroidism Under Pembrolizumab Across Gynecologic Malignancies and Melanoma: A Real\u2010World Cohort Study"],"prefix":"10.1002","author":[{"given":"Freya","family":"Koffka","sequence":"first","affiliation":[{"name":"Department of Gynecology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0266-5931","authenticated-orcid":false,"given":"Johann","family":"Kornowski","sequence":"additional","affiliation":[{"name":"Department of Gynecology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Laakmann","sequence":"additional","affiliation":[{"name":"Department of Gynecology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Schmalfeldt","sequence":"additional","affiliation":[{"name":"Department of Gynecology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8096-7402","authenticated-orcid":false,"given":"Tim","family":"Zell","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Fleur Hiege Center for Skin Cancer Research University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3999-5902","authenticated-orcid":false,"given":"Glenn","family":"Geidel","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Fleur Hiege Center for Skin Cancer Research University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoffer","family":"Gebhardt","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Fleur Hiege Center for Skin Cancer Research University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Roser","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkmar","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Gynecology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"K\u00f6tt","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Fleur Hiege Center for Skin Cancer Research University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"issue":"23","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.1056\/NEJMra2034861","article-title":"Recent Advances in the Treatment of Melanoma","volume":"384","author":"Curti B. 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