The American Society of Clinical Oncology (ASCO) has reviewed complications associated with immune checkpoint inhibitor therapy.
Patient selection: primary hypothyroidism following therapy with an immune checkpoint inhibitor
Parameters:
(1) clinical signs and symptoms
(2) serum TSH concentration in mIU/L
(3) ability to perform activities of daily living (ADL)
|
Clinical
|
Serum TSH
|
ADL
|
Grade
|
|
none or mild
|
> 4.5 to 10 mIU/L
|
able to perform
|
G1
|
|
moderate
|
> 10 mIU/L
|
able to perform
|
G2
|
|
severe
|
> 10 mIU/L
|
unable to perform
|
G3
|
|
life-threatening
|
> 10 mIU/L
|
unable to perform
|
G4
|
where:
• The serum TSH concentration of 4.5 mIU/L should be the upper limit of normal.
The diagnosis requires exclusion of pre-existing hypothyroidism or of other causes.
