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Endocrine toxicity of immune checkpoint inhibitors: essential crosstalk between endocrinologists and oncologists

Frédéric Illouz1, Claire Briet1,2, Lucie Cloix3

  • 1Department of Endocrinology, Diabetes and Nutrition, Reference Centre of Rare Thyroid Disease, Hospital of Angers, Angers Cedex 09, F-49933, France.

Cancer Medicine
|July 19, 2017
PubMed

Insights

Immune checkpoint inhibitors targeting CTLA-4 and PD-1 can cause endocrine toxicities like thyroid dysfunction. This review clarifies diagnosis, severity assessment, treatment, and management strategies for these adverse events.

Area of Science:

  • Immunology
  • Endocrinology
  • Oncology

Background:

  • Immune checkpoint inhibitors (ICIs) targeting cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed cell death-protein 1 (PD-1) are approved for melanoma, non-small-cell lung cancer, and renal cell carcinoma.
  • Adverse events associated with ICIs are often immune-related, including endocrine toxicities.

Purpose of the Study:

  • To address preconceptions and misconceptions surrounding endocrine dysfunctions induced by ICIs.
  • To identify areas of uncertainty and unmet needs in managing ICI-related endocrine toxicities.
  • To highlight the importance of collaboration between endocrinologists and oncologists.

Main Methods:

  • Literature review and expert discussion.
  • Identification and analysis of five key issues in managing endocrine toxicity.

Main Results:

  • Five critical areas for discussion were identified: diagnosis, severity assessment, treatment of endocrine toxicity, immunotherapy withdrawal/continuation, and preventive actions.
  • Emphasis on the need for clear guidelines and interdisciplinary communication.

Conclusions:

  • Addressing misconceptions and establishing standardized protocols are crucial for optimal patient care.
  • Enhanced collaboration between endocrinologists and oncologists is essential for managing immune-related endocrine adverse events effectively.
Keywords:
Adverse eventsendocrine toxicityimmune checkpoint inhibitorsimmunotherapythyroid dysfunction

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