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<b><sup>1</sup> NCCN 2023.</b> Thompson JA, et al. Management of Immunotherapy-Related Toxicities, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology. Epub 2023 Mar 10. <a href=https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1486><u>Accessed 04/24/2023</u></a>.
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<b><sup>2</sup> ASCO 2021.</b> Schneider BJ, et al. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update. <i>J Clin Oncol.</i> 2021 Dec 20;39(36):4073-4126. <a href=https://ascopubs.org/doi/pdf/10.1200/JCO.21.01440><u>Accessed 04/20/2023</u></a>.
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<b><sup>3</sup> SITC 2021.</b> Brahmer JR, et al. Society for Immunotherapy of Cancer (SITC) Clinical Practice Guideline on Immune Checkpoint Inhibitor-Related Adverse Events. <i>J Immunother Cancer.</i> 2021 Jun;9(6):e002435. <a href=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8237720/pdf/jitc-2021-002435.pdf><u>Free full-text PDF at PubMed® Central</u></a>. Accessed 04/20/2023.
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<b><sup>2</sup> ASCO 2021.</b> Schneider BJ, et al. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update. <i>J Clin Oncol.</i> 2021 Dec 20;39(36):4073-4126. <a href=https://ascopubs.org/doi/pdf/10.1200/JCO.21.01440><u>Accessed 04/20/2023</u></a>.
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<b><sup>3</sup> SITC 2021.</b> Brahmer JR, et al. Society for Immunotherapy of Cancer (SITC) Clinical Practice Guideline on Immune Checkpoint Inhibitor-Related Adverse Events. <i>J Immunother Cancer.</i> 2021 Jun;9(6):e002435. <a href=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8237720/pdf/jitc-2021-002435.pdf><u>Free full-text PDF at PubMed® Central</u></a>. Accessed 04/20/2023.
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Defined as low or suppressed TSH (<0.01 mIU/L) due to thyroiditis, w/ high free T4 (and/or high total T3). Most pts w/ thyrotoxicosis are asymptomatic. If present, sx may include palpitations, heat intolerance, restlessness or anxiety, fine tremor, and/or wt loss. Thyrotoxicosis occurs in ~5% of pts receiving anti–PD-1/PD-L1 ICPi and in 4% of pts receiving anti–CTLA-4 ICPi, and rarely may lead to Graves dz. Approximately 50% to 90% of thyrotoxicosis cases evolve into hypothyroidism, requiring long-term levothyroxine replacement. Median time to thyrotoxicosis is 5wk after ICPi initiation; usual duration is 4-6wk.<sup>1-3</sup>