{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:20:05Z","timestamp":1774952405056,"version":"3.50.1"},"reference-count":23,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Immune checkpoint inhibitors (ICIs) improve lung cancer prognosis but are associated with immune-related adverse events, most commonly thyroid dysfunction. While prior studies and guidelines have focused on thyroid dysfunction during ICI therapy, data on hypothyroidism and its monitoring after ICI therapy remain limited. We aimed to investigate hypothyroidism incidence and implementation of thyroid function monitoring after ICI therapy completion in patients with lung cancer. We conducted a retrospective observational study using the DeSC claims database of approximately 12 million individuals in Japan. Patients with lung cancer who received ICI therapy between April 2014 and August 2023 were included; those with a history of thyroid hormone replacement or insufficient follow-up were excluded. Among 6883 eligible patients, 277 (4.0%) developed hypothyroidism requiring hormone replacement post-ICI therapy completion (median onset, 67.0 d). Risk factors included ICI plus bevacizumab therapy and a history of myasthenia gravis, while steroid use for \u226528 d during ICI therapy lowered the risk. Post-ICI therapy completion thyroid monitoring was performed in 73.7% of patients, with test date distribution showing a median of 126.0 d and mode of 21.0 d. Hypothyroidism was frequently found to develop within 2 months post-ICI therapy completion, highlighting the need for continued thyroid monitoring and prospective studies to establish optimal surveillance strategies.<\/jats:p>","DOI":"10.3390\/curroncol32100558","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T13:33:41Z","timestamp":1759757621000},"page":"558","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Incidence of Hypothyroidism and Thyroid Function Monitoring After Immune Checkpoint Inhibitor Therapy Completion for Lung Cancer: A Nationwide Analysis of a Japanese Claims Database"],"prefix":"10.3390","volume":"32","author":[{"given":"Hiroaki","family":"Ohta","sequence":"first","affiliation":[{"name":"Education and Research Unit for Comprehensive Clinical Pharmacy, Department of Medicinal Therapy Research, Meiji Pharmaceutical University, Tokyo 204-8588, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hinako","family":"Tsugane","sequence":"additional","affiliation":[{"name":"Education and Research Unit for Comprehensive Clinical Pharmacy, Department of Medicinal Therapy Research, Meiji Pharmaceutical University, Tokyo 204-8588, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0587-0091","authenticated-orcid":false,"given":"Takeo","family":"Yasu","sequence":"additional","affiliation":[{"name":"Education and Research Unit for Comprehensive Clinical Pharmacy, Department of Medicinal Therapy Research, Meiji Pharmaceutical University, Tokyo 204-8588, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1056\/NEJMoa1910231","article-title":"Nivolumab plus ipilimumab in advanced non-small-cell lung cancer","volume":"381","author":"Hellmann","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1056\/NEJMoa1501824","article-title":"Pembrolizumab for the treatment of non-small-cell lung cancer","volume":"372","author":"Garon","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1056\/NEJMoa1507643","article-title":"Nivolumab versus docetaxel in Advanced nonsquamous Non-Small-Cell Lung Cancer","volume":"373","author":"Borghaei","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1056\/NEJMoa1504627","article-title":"Nivolumab versus docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer","volume":"373","author":"Brahmer","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1001\/jamaoncol.2017.2925","article-title":"Association of immune-related adverse events with nivolumab efficacy in non-small-cell lung cancer","volume":"4","author":"Haratani","year":"2018","journal-title":"JAMA Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1007\/s11912-023-01462-w","article-title":"Immune-related adverse events in patients with lung cancer","volume":"25","author":"Pai","year":"2023","journal-title":"Curr. Oncol. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"582","DOI":"10.6004\/jnccn.2024.0057","article-title":"NCCN guidelines\u00ae insights: Management of immunotherapy-related toxicities, version 2.2024","volume":"22","author":"Thompson","year":"2024","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/j.annonc.2022.10.001","article-title":"Management of toxicities from immunotherapy: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"33","author":"Haanen","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"R207","DOI":"10.1530\/EC-20-0342","article-title":"Management of endocrine immune-related adverse events of immune checkpoint inhibitors: An updated review","volume":"9","year":"2020","journal-title":"Endocr. Connect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.ejca.2021.03.010","article-title":"Late-onset and long-lasting immune-related adverse events from immune checkpoint-inhibitors: An overlooked aspect in immunotherapy","volume":"149","author":"Ghisoni","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-22-0689","article-title":"Endocrine-related adverse conditions in patients receiving immune checkpoint inhibition: An ESE clinical practice guideline","volume":"187","author":"Husebye","year":"2022","journal-title":"Eur. J. Endocrinol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"pky021","DOI":"10.1093\/jncics\/pky021","article-title":"The current understanding of the endocrine effects from immune checkpoint inhibitors and recommendations for management","volume":"2","author":"Girotra","year":"2018","journal-title":"JNCI Cancer Spectr."},{"key":"ref_13","unstructured":"National Cancer Institute (2025, August 25). Common Terminology Criteria for Adverse Events (CTCAE), Version 5.0, Available online: https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/ctc.htm."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/bmt.2012.244","article-title":"Investigation of the freely available easy-to-use software \u2018EZR\u2019 for medical statistics","volume":"48","author":"Kanda","year":"2013","journal-title":"Bone Marrow Transplant."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e6879","DOI":"10.1002\/cam4.6879","article-title":"Incidence and risk factors of immune-related adverse events induced by immune checkpoint inhibitors among older adults with non-small cell lung cancer","volume":"13","author":"Rong","year":"2024","journal-title":"Cancer Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1001\/jamaoncol.2017.3064","article-title":"Incidence of endocrine dysfunction following the use of different immune checkpoint inhibitor regimens: A systematic review and meta-analysis","volume":"4","author":"Barry","year":"2018","journal-title":"JAMA Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.lungcan.2021.08.009","article-title":"Immune checkpoint inhibitor induced thyroid dysfunction is a frequent event post-treatment in NSCLC","volume":"161","author":"Zhou","year":"2021","journal-title":"Lung Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1038\/s41698-021-00197-w","article-title":"Bevacizumab improves tumor infiltration of mature dendritic cells and effector T-cells in triple-negative breast cancer patients","volume":"5","author":"Boucher","year":"2021","journal-title":"NPJ Precis. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ejca.2017.12.008","article-title":"Safety and efficacy of anti-programmed death 1 antibodies in patients with cancer and pre-existing autoimmune or inflammatory disease","volume":"91","author":"Danlos","year":"2018","journal-title":"Eur. J. Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"7457","DOI":"10.1002\/cam4.4239","article-title":"Preexisting immune-mediated inflammatory disease is associated with improved survival and increased toxicity in melanoma patients who receive immune checkpoint inhibitors","volume":"10","author":"Gulati","year":"2021","journal-title":"Cancer Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"641","DOI":"10.7326\/M20-3419","article-title":"Safety and efficacy of checkpoint inhibition in patients with melanoma and preexisting autoimmune disease: A cohort study","volume":"174","author":"Suijkerbuijk","year":"2021","journal-title":"Ann. Intern. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.mce.2013.01.026","article-title":"Optimized glucocorticoid therapy: Teaching old drugs new tricks","volume":"380","author":"Strehl","year":"2013","journal-title":"Mol. Cell Endocrinol."},{"key":"ref_23","first-page":"394","article-title":"Drug-induced hypothyroidism","volume":"77","author":"Rizzo","year":"2017","journal-title":"Medicina"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/10\/558\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T04:15:17Z","timestamp":1760069717000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/10\/558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,4]]},"references-count":23,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["curroncol32100558"],"URL":"https:\/\/doi.org\/10.3390\/curroncol32100558","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,4]]}}}