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[Immune checkpoint inhibitors and endocrinological side effects]
Line Bisgaard Jørgensen1, Lars Bastholt, Knud Yderstræde
1line.bisgaard.joergensen@rsyd.dk.
Ugeskrift for Laeger
|December 8, 2017
Summary
Immune checkpoint inhibitors can cause hormonal dysfunction. Close monitoring of hormone levels and blood sugar is recommended during and after cancer treatment to manage these immune-related adverse events.
Area of Science:
- Oncology
- Immunology
- Endocrinology
Background:
- Immune checkpoint inhibitors (ICIs) like anti-cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) and anti-programmed cell death-1 (PD-1) have transformed cancer therapy.
- These immunotherapies can trigger immune-related adverse events (irAEs), including significant endocrine dysfunctions.
Purpose of the Study:
- To review the incidence, clinical presentation, management, and prognosis of endocrine irAEs associated with ICIs.
- To characterize specific endocrine toxicities such as hypophysitis, thyroid dysfunction, and diabetes mellitus.
Main Methods:
- Systematic review of literature on endocrine irAEs in patients treated with ICIs.
- Analysis of clinical data regarding presentation, diagnosis, and treatment outcomes.
Main Results:
- Endocrine adverse events are a notable complication of ICI therapy.
- Combination ICI therapy appears to increase the risk of these adverse events.
- Hypophysitis, thyroid dysfunction, and ICI-induced diabetes mellitus are key endocrine toxicities.
Conclusions:
- Endocrine irAEs require careful monitoring and management during and after ICI treatment.
- Monitoring hormone levels and glycemic status is crucial for early detection and intervention.
- Prognosis depends on timely diagnosis and appropriate management of endocrine complications.
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