{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:06:58Z","timestamp":1786122418362,"version":"build-2736575974"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"\n Background<\/jats:title>\n Real-world findings regarding the risk factors for immune checkpoint inhibitor (ICI) -related conditions remain scarce and show a lack of consistency.<\/jats:p>\n <\/jats:sec>\n \n Research design and methods<\/jats:title>\n We conducted a retrospective study of patients who treated with ICIs between October 2014 and June 2023. Patient follow-up was extended until death or July 4, 2025. Logistic regression was used to investigate the associations between clinical characteristics and thyroid dysfunction after ICI initiation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After excluding 411 patients with missing key data and 1,342 with pre-existing thyroid dysfunction, 6,857 patients were included in the final cohort. ICI-related thyroid dysfunction was identified in 1,342 cases (19.57% overall), with 582 subclinical hypothyroidism, 155 overt hypothyroidism, 521 central hypothyroidis, and 84 thyrotoxicosis. Logistic regression identified subtype-specific risk factors. For subclinical hypothyroidism, smoking (OR 0.766, 95% CI: 0.589-0.996,\n P<\/jats:italic>\n =\u00a00.047), lung cancer (OR 0.708, 95% CI: 0.567-0.884,\n P<\/jats:italic>\n \u00a0=\u00a00.002), and esophageal cancer (OR 0.544, 95% CI: 0.360-0.821,\n P<\/jats:italic>\n \u00a0=\u00a00.004) were protective, while hepatocellular carcinoma (OR 1.871, 95% CI: 1.438-2.433,\n P<\/jats:italic>\n \u00a0&lt;\u00a00.001) was a risk factor. For overt hypothyroidism, increasing age (OR 0.978, 95% CI: 0.965-0.990,\n P<\/jats:italic>\n \u00a0=\u00a00.001) and gastric cancer (OR 0.279, 95% CI: 0.101-0.771,\n P<\/jats:italic>\n \u00a0=\u00a00.014) were protective, whereas PD-L1 inhibitor use (OR 1.695, 95% CI: 1.017-2.825,\n P<\/jats:italic>\n \u00a0=\u00a00.043) increased risk. For central hypothyroidism, hepatocellular carcinoma (OR 0.473, 95% CI: 0.310-0.723,\n P<\/jats:italic>\n \u00a0=\u00a00.001) and esophageal cancer (OR 0.552, 95% CI: 0.360-0.846,\n P<\/jats:italic>\n \u00a0=\u00a00.006) were protective, and gastric cancer (OR 1.374, 95% CI: 1.005-1.878,\n P<\/jats:italic>\n \u00a0=\u00a00.047) was a risk factor. For thyrotoxicosis, male sex (OR 0.578, 95% CI: 0.358-0.934,\n P<\/jats:italic>\n \u00a0=\u00a00.025) was protective, while esophageal cancer (OR 2.639, 95% CI: 1.306-5.334,\n P<\/jats:italic>\n \u00a0=\u00a00.007) was a risk factor.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This large real-world cohort reveals a high incidence of ICI-related thyroid dysfunction and identifies subtype-specific risk factors, underscoring the importance of routine thyroid function monitoring in high-risk patients receiving ICI therapy.<\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n https:\/\/www.chictr.org.cn<\/jats:ext-link>\n , identifier ChiCTR2300075974\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1882182","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T10:06:13Z","timestamp":1786097173000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world insights into incidence and risk factors of thyroid dysfunction following immune checkpoint inhibitor therapy"],"prefix":"10.3389","volume":"17","author":[{"given":"Lingyan","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Pharmacy, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinran","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, West China Hospital, Sichuan University","place":["Chengdu, China"]},{"name":"West China School of Pharmacy, Sichuan University","place":["Chengdu, China"]},{"name":"Department of Pharmacy, Institute of Metabolic Diseases and Pharmacotherapy, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Zhan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, West China Hospital, Sichuan University","place":["Chengdu, China"]},{"name":"West China School of Pharmacy, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1097\/js9.0000000000002830","article-title":"Immune checkpoint inhibitors against thyroid cancer","volume":"111","author":"Zhao","year":"2025","journal-title":"Int J 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