[Endocrinopathies induced by immune checkpoint inhibitors]

Area of Science:

• Oncology
• Endocrinology
• Immunology

Background:

• Immune checkpoint inhibitors (ICIs) are novel immunomodulatory treatments demonstrating significant anti-tumor efficacy in various advanced cancers.
• The use of ICIs has been associated with a spectrum of immune-related adverse events (irAEs) affecting multiple organ systems, including endocrine glands.

Purpose of the Study:

• To review the endocrine complications associated with immune checkpoint inhibitor therapy.
• To highlight the specific endocrine glands affected and the relative frequencies of these complications.

Main Methods:

• Literature review of immune checkpoint inhibitors and their associated endocrine adverse events.
• Analysis of reported cases and clinical trial data regarding endocrine irAEs.

Main Results:

• Hypophysitis is the most frequent endocrine complication associated with anti-CTLA-4 monoclonal antibodies.
• Anti-PD-1 and anti-PD-L1 antibodies are more commonly linked to thyroid-related complications.
• Adrenal insufficiency and type 1 diabetes are less common endocrine irAEs.

Conclusions:

• Endocrine complications are significant irAEs of immune checkpoint inhibitors, impacting the pituitary, thyroid, adrenal glands, and pancreas.
• Oncologists, endocrinologists, and primary care physicians must be knowledgeable about these potential side effects for effective patient management.
• Early recognition and management of endocrine irAEs are essential for maintaining treatment efficacy and patient well-being.