***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Programmed cell death protein-1 ( PD-1 ) blockade therapies have demonstrated durable responses and prolonged survival in a variety of malignancies . Treatment is generally well tolerated although immune-related adverse events ( irAEs ) can occur . Autoimmune thyroid dysfunction is among the most common irAE , but an assessment of the clinical , mechanistic , and immunologic features has not been previously described . Patient and methods Patients with advanced non-small-cell lung cancer ( NSCLC ) treated with pembrolizumab at Memorial Sloan Kettering Cancer Center ( n = 51 ) as part of KEYNOTE-001 ( NCT01295827 ) were included . Thyroid function test and anti-thyroid antibodies were assessed prospect ively at each study visit , beginning before the first treatment . Frequency of development of thyroid dysfunction , association with anti-thyroid antibodies , clinical course , and relationship with progression-free survival and overall survival to treatment with pembrolizumab was evaluated . Results Of 51 patients treated , 3 were hypothyroid and 48 were not at baseline . Ten of 48 [ 21 % , 95 % confidence interval ( CI ) 10 % to 35 % ] patients developed thyroid dysfunction requiring thyroid replacement . Anti-thyroid antibodies were present in 8 of 10 patients who developed thyroid dysfunction , compared with 3 of 38 who did not ( 80 % versus 8 % , P < 0.0001 ) . Thyroid dysfunction occurred early ( median , 42 days ) in the pembrolizumab course , and a majority ( 6 of 10 patients ) experienced brief , transient hyperthyroidism preceding the onset of hypothyroidism ; no persistent hyperthyroidism occurred . Both hyperthyroidism and hypothyroidism were largely asymptomatic . Overall survival with pembrolizumab was significantly longer in subjects who developed thyroid dysfunction ( hazard ratio , 0.29 ; 95 % CI 0.09 - 0.94 ; P = 0.04 ) . Conclusions Thyroid dysfunction during pembrolizumab treatment of NSCLC is common and is characterized by early-onset , frequently preceded by transient hyperthyroidism , closely associated with anti-thyroid antibodies , and may be associated with improved outcomes . The presence of antibody-mediated toxicity in T-cell-directed therapy suggests an under-recognized impact of PD-1 biology in modulating humoral immunity Purpose To increase awareness , outline strategies , and offer guidance on the recommended management of immune-related adverse events in patients treated with immune checkpoint inhibitor ( ICPi ) therapy .  Methods A multidisciplinary , multi-organizational panel of experts in medical oncology , dermatology , gastroenterology , rheumatology , pulmonology , endocrinology , urology , neurology , hematology , emergency medicine , nursing , trialist , and advocacy was convened to develop the clinical practice guideline . Guideline development involved a systematic review of the literature and an informal consensus process . The systematic review focused on guidelines , systematic review s and meta-analyses , r and omized controlled trials , and case series published from 2000 through 2017 . Results The systematic review identified 204 eligible publications . Much of the evidence consisted of systematic review s of observational data , consensus guidelines , case series , and case reports . Due to the paucity of high- quality evidence on management of immune-related adverse events , recommendations are based on expert consensus . Recommendations Recommendations for specific organ system-based toxicity diagnosis and management are presented . While management varies according to organ system affected , in general , ICPi therapy should be continued with close monitoring for grade 1 toxicities , with the exception of some neurologic , hematologic , and cardiac toxicities .  ICPi therapy may be suspended for most grade 2 toxicities , with consideration of resuming when symptoms revert to grade 1 or less . Corticosteroids may be administered . Grade 3 toxicities generally warrant suspension of ICPis and the initiation of high-dose corticosteroids ( prednisone 1 to 2 mg/kg/d or methylprednisolone 1 to 2 mg/kg/d ) . Corticosteroids should be tapered over the course of at least 4 to 6 weeks . Some refractory cases may require infliximab or other immunosuppressive therapy . In general , permanent discontinuation of ICPis is recommended with grade 4 toxicities , with the exception of endocrinopathies that have been controlled by hormone replacement . Additional information is available at www.asco.org/supportive-care- guidelines and www.asco.org/ guidelines wiki OBJECTIVES Patients treated with nivolumab  often experience its unique adverse events , called immune-related adverse events ( irAEs ) . Regarding the mechanisms of immune-checkpoint inhibitors ( ICIs ) , the occurrence of irAEs may also reflect antitumor responses . Here , we report the clinical correlation between irAEs and efficacy in NSCLC patients treated with nivolumab .  MATERIAL S AND METHODS Between December 2015 and February 2017 , 38 advanced NSCLC patients were treated in our institution . All the patients were enrolled in our single-institutional , prospect i ve , observational cohort study ( UMIN000024414 ) . IrAEs were defined as having a potential immunological basis that required more frequent monitoring and potential intervention . We divided the patients into two groups ( irAEs group or no-irAEs group ) and evaluated the  objective response rate ( ORR ) and progression-free survival ( PFS ) . RESULTS The median age of the patients was 68.5 years ( range 49 - 86 years ) ; male/female ratio was 28/10 ; squamous/non-squamous cell carcinoma cases were 10/28 ; performance status was 0 - 1/2/3 , 7/26/5 . Among the overall population , ORR was 23.7 % and median PFS was 91days . At the data cutoff , 14 irAEs were observed . The most common irAE was interstitial pneumonia ( n=5 ) . Other irAEs were hypothyroidism ( n=4 ) , hyperthyroidism , hypopituitarism , liver dysfunction , rash , and elevated thyroid stimulating hormone levels ( n=1 , each ) . Patients with irAEs had significantly higher ORRs compared with no-irAE patients ( 63.6 % versus 7.4 % , p < 0.01 ) . Similarly , the PFS among irAE patients was longer ( median : not reached [ 95 % confidence interval { CI } : 91days to not applicable ] ) than no-irAE patients ( median 49days [ 95 % CI : 36 - 127days ] , hazard ratio [ HR ] 0.10 [ 95 % CI : 0.02 - 0.37 , p<0.001 ] ) . L and mark analysis of patients who achieved PFS ≥60days demonstrated similar tendencies , but this was not significant ( HR 0.28 [ 95 % CI : 0.04 - 1.46 ] , p=0.13 ) . CONCLUSION There was a correlation between irAE and efficacy in NSCLC patients treated with nivolumab R and omized prospect i ve studies on patients with metastatic non‐small‐cell lung cancers ( NSCLCs ) showed that anti‐programmed death‐1 ( PD‐1 ) agents notably improved 2‐year overall survival ( OS ) rates , compared to docetaxel . NSCLC patients now receive nivolumab and irradiation , concurrently or not . However , little is known about the safety of this combination , even though the pre clinical model suggested a possible synergic effect . We analyzed NSCLC patients treated with radiotherapy and nivolumab according to former 's timing BACKGROUND Immune checkpoint inhibitors ( ICIs ) are available for first- and further lines of treatment of patients with advanced non-small-cell lung cancer ( NSCLC ) . These treatments are associated with adverse events called immune-related adverse events ( IRAEs ) . The incidence , diagnosis , and treatment of IRAEs are quite acknowledged ; however , the link between IRAEs and the efficacy of ICIs requires further clarification . The objectives of this study were to assess the association between IRAEs incidence and severity and ICIs efficacy in patients with advanced NSCLC . METHODS In this retrospective study , clinical , biological , treatment , and outcome data were collected from patients with advanced NSCLC who received at least 1 cycle of ICIs from April 2013 to February 2017 . The primary endpoint was to assess the association of IRAEs incidence with overall survival ( OS ) . Secondary endpoints were the association of IRAEs with progression-free survival ( PFS ) , objective response rate ( ORR ) , and disease control rate ( DCR ) . RESULTS Overall , 270 patients were studied . The median OS was 14 months , median PFS was 2.6 months , ORR was 13 % , and DCR was 51 % . OS , PFS , and ORR were significantly better for patients with IRAEs compared with patients with no IRAEs , translating to median OS not reached versus 8.21 months , respectively ( hazard ratio , 0.29 ; 95 % confidence interval [ CI ] , 0.18 - 0.46 ; P < .001 ) ; PFS was 5.2 versus 1.97 months ( hazard ratio , 0.42 ; 95 % CI , 0.32 - 0.57 ; P < .001 ) ; and ORR was 212.9 % versus 5.7 % ( odds ratio , 4.9 ; 95 % CI , 2.18 - 11.05 ; P < .001 ) . CONCLUSIONS This report presents the largest case series showing longer OS and PFS and better ORR when IRAEs occurred in a population of patients with advanced NSCLC treated with ICIs . The biological background for this phenomenon is being explored prospect ively Purpose We evaluated if the development of thyroiditis in patients who received treatment with immune checkpoint inhibitors across various tumor types was associated with tumor response . Methods In this retrospective , single-center , cross-sectional study , patients with various tumor types who received treatment with nivolumab or pembrolizumab as st and ard of care were evaluated . The primary endpoint was to evaluate the objective response rate in patients who developed thyroiditis compared with patients who did not develop thyroiditis . Secondary endpoints included disease control rate , progression-free survival , and overall survival . Results One hundred and three patients were included for analysis with a median follow-up duration of 12.8 months ( range , 4.0–21.6 ) . The data cutoff was 31 December 2016 . The objective response rate was 38.2 % among the 34 patients in the thyroiditis group and 17.4 % in the 69 patients in the non-thyroiditis group ( p = 0.028 ) . Progression-free survival was longer in the thyroiditis group than in the non-thyroiditis group . The median progression-free survival was 10.1 months ( 95 % CI , 1.6–18.5 ) in the thyroiditis group and 3.7 months ( 95 % CI , 2.5–4.9 ) in the non-thyroiditis group ( hazard ratio , 0.45 ; 95 % CI , 0.27–0.76 ; p = 0.002 ) . Conclusion Patients with various tumor types who received treatment with immune checkpoint inhibitors and developed thyroiditis had a higher objective response rate than those who did not develop thyroiditis . The development of thyroiditis should be investigated further in the context of prospect i ve r and omized trials as a surrogate marker for tumor response to treatment with immune checkpoint inhibitor therapies Abstract Background : To investigate effect and toxicity of immune checkpoint inhibition ( ICI ) in a Danish real-life non-small cell lung cancer ( NSCLC ) population . By including patients underrepresented in clinical trials , such as those with brain metastasis ( BM ) , higher age , more comorbidity and poorer performance status ( ECOG ) , comparison of unselected patients to clinical trial population s is possible . Material and methods : Real life data were gathered from 118 consecutive NSCLC patients with incurable NSCLC treated with ICI at the Department of Oncology at the University Hospital of Odense , Denmark from September 2015 to April 2018 .  Immune-related adverse events ( irAEs ) grade s 3–5 were registered prospect ively during the same period . Additional patient related data were obtained retrospectively from patients ' files . Overall survival ( OS ) and progression-free survival ( PFS ) were calculated using the Kaplan – Meier estimates , the log-rank test and cox regression analysis performed for factors affecting survival . Results :  Median age for patients was 66 years ( IQR 59–71 ) and 62 years ( range : 55–64 ) for those with BM . Females 63 % ; adenocarcinoma (AC)/squamous/others 69%/23%/8 % ; ECOG ≥ 2 10 % ; bone/brain/liver metastases 36%/18%/15 % ; PD-L1 ( TPS ) < 1%/ ≥ 1%/ ≤ 49%/ ≥ 50%/NR : 3%/14%/68%/15 % ; baseline autoimmunity 10 % , Charlson 's Comorbidity Index Score ( CCIS ) ≥ 2 39 % , treatment line : 1st/2nd/ ≥ 3rd 39 
    Output:
    
The occurrence of irAEs was significantly associated with a better ICI efficacy  in patients with cancer , particularly endocrine , dermatological , and low- grade irAEs .