Survival Outcomes Associated with Hypothyroidism Following Cancer Therapies
Authors' conclusion
Hypothyroidism after ICI and radiotherapy was associated with improved survival, supporting its potential as a prognostic biomarker of therapeutic benefit. Future studies should investigate the underlying mechanisms and clinical implications.
Study context
- Population
- Adults (≥18 years) receiving immune checkpoint inhibitors (ICIs), tyrosine kinase inhibitors (TKIs) or radiotherapy, without prior thyroid disease or malignancy; University of Michigan EHR data 2006–2023
- Participants
- 9,909 adults57,772 person-years
- Exposure
- Treatment-induced hypothyroidism vs no hypothyroidism
- Hypothyroidismn = 2,177
- Outcome
- Overall and cancer-specific survival
- Follow-up
- Median 4.64 years
Methodological detailstime-dependent Cox models, single institution (University of Michigan EHR)
- Time-dependent Cox models
- Single institution (University of Michigan EHR)
Main finding
As reported in the abstract
Each group vs no hypothyroidismEstimate (95% CI)P value
Hypothyroidism
HR (overall survival) 0.86(0.79–0.93)
P < 0.001Hypothyroidism
HR (cancer-specific survival) 0.76(0.70–0.84)
P < 0.001- Developed hypothyroidism
- 2177 (22.0%)
- Median onset time
- 5.04 months
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Survival, ICI subgroupHypothyroidismvs No hypothyroidism | HR (overall survival) 0.75 (95% CI 0.61–0.92) | P = 0.014 | |
| Survival, ICI subgroupHypothyroidismvs No hypothyroidism | HR (cancer-specific survival) 0.75 (95% CI 0.66–0.94) | P = 0.012 | |
| Survival, radiotherapy subgroupHypothyroidismvs No hypothyroidism | HR (overall survival) 0.88 (95% CI 0.81–0.96) | P = 0.011 | |
| Survival, radiotherapy subgroupHypothyroidismvs No hypothyroidism | HR (cancer-specific survival) 0.76 (95% CI 0.68–0.84) | P < 0.001 | |
| Survival by cancer siteBetween Hypothyroidism and No hypothyroidism | HR (brain/CNS) 0.39 (95% CI 0.26–0.61) | P < 0.001 | |
| Survival by cancer siteBetween Hypothyroidism and No hypothyroidism | HR (lip/oral cavity/pharyngeal) 0.77 (95% CI 0.61–0.97) | P = 0.032 | |
| Survival by cancer siteBetween Hypothyroidism and No hypothyroidism | HR (lung/bronchus) 0.80 (95% CI 0.66–0.97) | P = 0.034 | |
| Survival by cancer siteBetween Hypothyroidism and No hypothyroidism · higher mortality | HR (colon) 1.82 (95% CI 1.10–3.02) | P = 0.021 | |
| 0.20.5125Ratio (log scale) |
Survival, TKI subgroup
- No significant survival benefit with hypothyroidism following TKI
Sensitivity analyses
- Results were consistent across sensitivity analyses
Original publication
Survival Outcomes Associated with Hypothyroidism Following Cancer Therapies. Thyroid. Published 9 May 2026. doi:10.
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