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Endocrine-related adverse events associated with immune checkpoint blockade and expert insights on their management

Mario Sznol1, Michael A Postow2, Marianne J Davies3

  • 1Yale University School of Medicine and Yale Cancer Center, New Haven, CT, USA.

Cancer Treatment Reviews
|July 10, 2017
PubMed

Insights

Immune checkpoint inhibitors for cancer can cause endocrine-related side effects affecting glands like the pituitary and thyroid. Early recognition and management are key for safe treatment.

Area of Science:

  • Oncology
  • Immunology
  • Endocrinology

Background:

  • Immune checkpoint inhibitors targeting CTLA-4 and PD-1 are crucial cancer therapies.
  • These therapies can lead to immune-related adverse events (irAEs) affecting various organs.
  • Endocrine irAEs impact the pituitary, thyroid, and adrenal glands, often irreversibly.

Purpose of the Study:

  • To review the characteristics of immune-related endocrine events associated with immune checkpoint inhibitors.
  • To highlight the diagnostic challenges and management strategies for these events.
  • To emphasize the importance of awareness for safe clinical practice.

Main Methods:

  • Literature review of immune checkpoint inhibitors and their associated endocrine adverse events.
  • Analysis of the presentation, diagnosis, and management of immune-related endocrine events.
  • Synthesis of current understanding regarding mechanisms and clinical implications.

Main Results:

  • Immune-related endocrine events are common, often irreversible, and present with non-specific symptoms.
  • Diagnosis can be challenging due to mild severity (Grade 1/2) and subtle manifestations.
  • Management involves monitoring, hormone replacement, and specialist consultation.

Conclusions:

  • Immune-related endocrine events require vigilant monitoring and prompt management.
  • Understanding these events is crucial for the safe and effective use of immune checkpoint inhibitors.
  • Further research into underlying mechanisms may improve patient outcomes.
Keywords:
HypophysitisImmune-related adverse eventsIpilimumabMelanomaNivolumabThyroiditis

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