帕博利珠单抗相关的甲状腺功能障碍与转移性癌症患者更好的预后相关。本研究旨在检查接受术前治疗且出现派姆单抗相关甲状腺功能障碍的早期三阴性乳腺癌 (TNBC) 患者的结果（病理完全缓解 (pCR) 和无事件生存 (EFS)）。根据派姆单抗相关甲状腺功能障碍的发生与否将患者分为四组（分别为 A 组和 D 组），如果先前存在甲状腺疾病，则根据是否需要开始/调整左甲状腺素（组分别为 B 和 C）。将A、B、C组的pCR和EFS与D组进行比较。纳入64名早期TNBC患者，中位随访时间为16.5个月（IQR 12.0-23.8）。观察到多种甲状腺 irAE 模式（显性甲状腺功能减退症占 56.3%，亚临床甲状腺毒症占 28.1%，显性甲状腺毒症和亚临床甲状腺功能减退症占 21.9%，21.9% 的患者）。 A、B、C 组与 D 组相比，pCR（卡方检验，P = 0.611）没有发现统计学差异。A、B、C 组和 D 组的中位 EFS 为 16.5（IQR 12.0-分别为 24.0) 和 16.0 (IQR 12.0-22.3) 个月（对数秩检验，P = 0.671）。在发生帕博利珠单抗相关的明显甲状腺毒症的患者中，获得 pCR 的患者百分比为 85.7%，在其余患者中为 42.1%（卡方检验，P = 0.036）。发生派姆单抗相关的明显甲状腺毒症的患者的 EFS 为 16.0 个月（IQR 12.0-25.0），其余患者的 EFS 为 16.0 个月（IQR 12.0-23.5）（对数秩检验，P = 0.494）。总之，早期 TNBC 中会出现多种与派姆单抗相关的甲状腺功能障碍。发生帕博利珠单抗相关的明显甲状腺毒症的患者更有可能实现 pCR。

Pembrolizumab-related thyroid dysfunction has been associated with better outcomes in metastatic cancer patients. This study aims to examine the outcomes (pathological complete response (pCR) and event-free survival (EFS)) in early-stage triple-negative breast cancer (TNBC) patients receiving preoperative therapy who developed pembrolizumab-related thyroid dysfunction. Patients were divided into four groups based on the occurrence or not of pembrolizumab-related thyroid dysfunction (group A and D, respectively) and, in case of pre-existing thyroid disorder, based on the need for levothyroxine start/adjustment or not (group B and C, respectively). pCR and EFS in groups A, B, and C were compared to the ones in group D. Sixty-four early-stage TNBC patients were included, and the median follow-up was 16.5 months (IQR 12.0-23.8). Multiple patterns of thyroid irAEs were observed (overt hypothyroidism in 56.3%, subclinical thyrotoxicosis in 28.1%, overt thyrotoxicosis and subclinical hypothyroidism in 21.9%, and 21.9% of patients). No statistical difference was found in pCR (chi-square test, P = 0.611) comparing groups A, B, and C to group D. The median EFS in groups A, B, and C and in group D were 16.5 (IQR 12.0-24.0) and 16.0 (IQR 12.0-22.3) months, respectively (log-rank test, P = 0.671). The percentage of patients obtaining pCR was 85.7% in patients developing pembrolizumab-related overt thyrotoxicosis and 42.1% in remaining patients (chi-square test, P = 0.036). The EFS was 16.0 months (IQR 12.0-25.0) in patients developing pembrolizumab-related overt thyrotoxicosis and 16.0 months (IQR 12.0-23.5) in the remaining patients (log-rank test, P = 0.494). In conclusion, multiple patterns of pembrolizumab-related thyroid dysfunction occur in early-stage TNBC. Patients developing pembrolizumab-related overt thyrotoxicosis are more likely to achieve pCR.