Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Mar 14:31:1612022.
doi: 10.3389/pore.2025.1612022. eCollection 2025.

Are patients with chronic obstructive pulmonary disease at a greater risk for the development of autoimmune thyroiditis as an adverse event of immunotherapy in non-small cell lung cancer treatment?

Andrej Zecevic  1 , Ana Blanka-Protic  1 , Aleksandar Jandric  1 , Tatjana Adzic-Vukicevic  1   2
Affiliations
Observational Study

Are patients with chronic obstructive pulmonary disease at a greater risk for the development of autoimmune thyroiditis as an adverse event of immunotherapy in non-small cell lung cancer treatment?

Andrej Zecevic et al. Pathol Oncol Res. .

Abstract

Introduction: Immunotherapy has made a significant improvement in the treatment of patients with non-small cell lung cancer (NSCLC). It has a role in boosting the immune system, so it can fight cancer cells. Sometimes, this mechanism can lead to an overstimulation or misdirection of immune response, so it can act against the body itself. One of the organs most affected by this reaction is the thyroid gland, and there is no definitive explanation of the causes of this adverse event.

Material and methods: In this retrospective observational study, we enrolled 103 patients with NSCLC and high PD-L1 expression (>= 50%) who were treated in our Clinic for pulmonology, University Clinical Center of Serbia, using Pembrolizumab as the first-line therapy.

Results: Data analysis showed that 41 (39.81%) of 103 patients in our study had an adverse event of immunotherapy, and 21 of them had autoimmune thyroiditis (20.39%). Of all the patients, 19 of them were treated for chronic obstructive pulmonary disease (COPD) before the onset of Pembrolizumab. During treatment, eight of these patients developed thyroid dysfunction. Patients with COPD were at increased risk of developing autoimmune thyroiditis compared to non-COPD patients (OR 3.9 95% CI 1.135-13.260, p = 0.0227).

Conclusion: Our study showed that patients dealing with COPD have a 3.9 times greater risk of developing autoimmune thyroiditis as an adverse event during Pembrolizumab treatment compared with patients without COPD.

Keywords: adverse event; chronic obstructive lung disease; immunotherapy; non-small cell lung cancer; thyroiditis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Durham AL, Adcock IM. The relationship between COPD and lung cancer. Lung Cancer (2015) 90(2):121–7. 10.1016/j.lungcan.2015.08.017 - DOI - PMC - PubMed
    1. Qi C, Sun SW, Xiong XZ. From COPD to lung cancer: mechanisms linking, diagnosis, treatment, and prognosis. Int J Chron Obstruct Pulmon Dis (2022) 17:2603–21. 10.2147/COPD.S380732 - DOI - PMC - PubMed
    1. Forder A, Zhuang R, Souza VGP, Brockley LJ, Pewarchuk ME, Telkar N, et al. Mechanisms contributing to the comorbidity of COPD and lung cancer. Int J Mol Sci (2023) 24(3):2859. 10.3390/ijms24032859 - DOI - PMC - PubMed
    1. Lahiri A, Maji A, Potdar PD, Singh N, Parikh P, Bisht B, et al. Lung cancer immunotherapy: progress, pitfalls, and promises. Mol Cancer (2023) 22(1):40. 10.1186/s12943-023-01740-y - DOI - PMC - PubMed
    1. Steven A, Fisher SA, Robinson BW. Immunotherapy for lung cancer. Respirology (2016) 21(5):821–33. 10.1111/resp.12789 - DOI - PubMed

Publication types

MeSH terms

Substances