Association of basal thyroid function with clinical outcomes in patients with recurrent or metastatic nasopharyngeal carcinoma treated with PD-L1 inhibitor KL-A167: a multicenter post hoc analysis.

In line with the observed survival trends, the ORR was numerically higher in the high TSH group, although this difference did not reach statistical significance ( P = 0.23).

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After adjustment for relevant covariates, including age, BMI, gender, ECOG performance status, and disease stage, high basal TSH levels showed a trend toward association with improved therapeutic response, although the associations did not reach statistical significance.

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A particularly strong association was noted in the high BMI subgroup (≥24), where the hazard ratio for death was 0.27 (95% CI: 0.09–0.83; P = 0.02), with a borderline significant interaction P value of 0.06, suggesting that higher body mass might amplify the protective effect of TSH.

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