甲状腺功能失调（DT）是免疫检查点抑制剂（ICIs）的常见毒副作用，先前的研究表明，甲状腺功能失调（DT）可能与ICI的疗效相关。本回顾性研究使用新一代数据挖掘解决方案ConSoRe，从法国马赛市Paoli-Calmettes研究所的成年癌症患者接受ICI治疗的电子病历中提取数据。每个DT都经过验证，只保留ICI诱发的DT。采用Kaplan-Meier方法（对数秩检验）和Cox模型进行生存分析。为了解决不可避免的时间偏差，进行了条件里程碑分析（2个月和6个月），结合时变Cox模型。数据提取确定2011年至2021年间共有1385名接受ICI治疗的患者。DT与改善总生存期相关（HR为0.46，95％CI为0.33至0.65，p<0.001），DT组的中位总生存期为35.3个月，非DT组（NDT）的中位总生存期为15.4个月。使用6个月里程碑分析，DT的生存影响保持一致，DT组的中位总生存期为36.7个月（95％CI为29.4至不报告）和NDT组的25.5个月（95％CI为22.8至27.8）。在多变量分析中，DT与改善总生存期独立相关（HR为0.49，95％CI为0.35至0.69，p=0.001）。在时变Cox模型中进行调整后，这一关联仍然显著（调整HR为0.64，95％CI为0.45至0.90，p=0.010）。此外，与孤立DT患者相比，DT并发其他免疫相关不良事件的患者具有增加的总生存期，中位总生存期分别为38.8个月和21.4个月。数据挖掘确定了大量ICI诱发DT患者，考虑到不可避免的时间偏差，与改善总生存期相关。© 作者（或其雇主）2023。在CC BY-NC许可下允许再使用。不得进行商业再使用。由BMJ出版。

Dysthyroidism (DT) is a common toxicity of immune checkpoint inhibitors (ICIs) and prior work suggests that dysthyroidism (DT) might be associated with ICI efficacy.ConSoRe, a new generation data mining solution, was used in this retrospective study, to extract data from electronic patient records of adult cancer patients treated with ICI at Institut Paoli-Calmettes (Marseille, France). Every DT was verified and only ICI-induced DT was retained. Survival analyses were performed by Kaplan-Meier method (log-rank test) and Cox model. To account for immortal time bias, a conditional landmark analysis was performed (2 months and 6 months), together with a time-varying Cox model.Data extraction identified 1385 patients treated with ICI between 2011 and 2021. DT was associated with improved overall survival (OS) (HR 0.46, (95% CI 0.33 to 0.65), p<0.001), with a median OS of 35.3 months in DT group vs 15.4 months in non-DT group (NDT). Survival impact of DT was consistent using a 6-month landmark analysis with a median OS of 36.7 months (95% CI 29.4 to not reported) in the DT group vs 25.5 months (95% CI 22.8 to 27.8) in the NDT group. In multivariate analysis, DT was independently associated with improved OS (HR 0.49, 95% CI 0.35 to 0.69, p=0.001). After adjustment in time-varying Cox model, this association remained significant (adjusted HR 0.64, 95% CI 0.45 to 0.90, p=0.010). Moreover, patients with DT and additional immune-related adverse event had increased OS compared with patients with isolated DT, with median OS of 38.8 months vs 21.4 months, respectively.Data mining identified a large number of patients with ICI-induced DT, which was associated with improved OS accounting for immortal time bias.© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.