免疫检查点抑制剂（ICIs）常见的免疫相关不良事件（irAE）是甲状腺功能障碍（TD-irAE）。临床表现多种多样，其与预后的关系仍不清楚。我们研究了 TD-irAE 的特征及其与现实生活中接受 ICI 治疗的癌症患者临床结果的关联。使用 RECIST v1.1 评估治疗反应。我们使用多变量调整回归和 Cox 比例风险模型计算了与 TD-irAE 相关的复发概率和生存率。在这项单中心回顾性分析中，我们纳入了 238 名患者（72% 男性），中位年龄为 69.5 岁。原发性肿瘤为黑色素瘤 (23.1%)、肺癌 (60.5%) 或尿路上皮癌 (16.4%)，接受阿替利珠单抗 (23.1%)、派姆单抗 (44.5%)、易普利姆玛 (0.4%) 和/或纳武单抗 (25.6%) 治疗）。 70 名 (29%) 患者在 69 天的中位时间内出现 TD-irAE (41-181)。联合治疗的 TD-irAE 发生率高于单药治疗（67% vs 6.3%，P = 0.011）。 TD-irAE 患者比没有 TD-irAE 的患者表现出更高的客观缓解率 (ORR)（60% vs 42.3%，P = 0.013）和更长的总生存期 (OS)（45 个月 vs 16 个月，P < 0.006）。出现 TD-irAE 的患者的进展风险相对降低了 77%（OR 0.23，95% CI 0.11-0.47），死亡风险相对降低了 47%（HR 0.53，95% CI 0.36-0.80）。与年龄、性别、原发肿瘤或 ICI 方案无关。在我们接受 ICI 的患者中，近 30% 发生 TD-irAE。在我们的分析中，TD-irAE 似乎与较高的 ORR 和较长的 OS 相关，并显示出进展和死亡率风险的降低。

A common immune-related adverse event (irAE) with immune checkpoint inhibitors (ICIs) is thyroid dysfunction (TD-irAEs). The clinical presentation can be varied, and its association with prognosis remains unclear. We investigated the characteristics of TD-irAEs and their association with clinical outcomes among cancer patients treated with ICIs in a real-life setting. Response to treatment was assessed using RECIST v1.1. We calculated the probability of recurrence and survival associated with TD-irAEs using multivariable-adjusted regression and Cox proportional hazards models. In this single-center retrospective analysis, we included 238 patients (72% male) with a median age of 69.5 years. Primary tumors were melanoma (23.1%), lung (60.5%), or urothelial cancer (16.4%), treated with atezolizumab (23.1%), pembrolizumab (44.5%), ipilimumab (0.4%), and/or nivolumab (25.6%). Seventy (29%) patients developed TD-irAEs in a median time of 69 days (41-181). The incidence of TD-irAEs with combination therapy was higher than with monotherapy (67% vs 6.3%, P = 0.011). TD-irAE patients showed a higher objective response rate (ORR) than those without TD-irAEs (60% vs 42.3%, P = 0.013) and longer overall survival (OS) 45 vs 16 months, P < 0.006. Patients who developed TD-irAEs had a relative reduction of 77% (OR 0.23, 95% CI 0.11-0.47) in the risk of progression and of 47% in the risk of mortality (HR 0.53, 95% CI 0.36-0.80), independent of age, sex, primary tumor, or ICI regimen. TD-irAEs occur in nearly 30% of our patients receiving ICIs. In our analysis, TD-irAEs appeared to be associated with higher ORR and longer OS and showed a reduction in the risk of progression and mortality.