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Q. Should an asymptomatic endocrinopathy be treated?
ANSWER FROM KATHY MADDEN:
A transient period of asymptomatic hyperthyroidism can sometimes be observed with PD-1 inhibitor monotherapy, but it is more commonly observed early in treatment with combination nivolumab/ipilimumab.
This period is typically followed by hypothyroidism, which can be clinically detectable and often requires permanent hormone replacement therapy.
(In the Checkmate 067 phase III trial, among patients treated with combo therapy, 15% of patients experienced hypothyroidism of any grade.)