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Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
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Expert opinion on thyroid complications in immunotherapy.
Frederic Illouz1, Delphine Drui2, Philippe Caron3
1Department of Endocrinology, Diabetes and Nutrition, Reference Centre of Rare Thyroid and Hormonal Receptors Disease, Hospital of Angers, 49933 Angers cedex 09, France.
Annales D'Endocrinologie
|August 22, 2018
Summary
Thyroid dysfunction is common with cancer immunotherapy, often presenting as transient thyrotoxicosis followed by hypothyroidism. Early screening and management, including levothyroxine for hypothyroidism, are key to patient care.
Area of Science:
- Endocrinology
- Oncology
- Immunology
Background:
- Thyroid pathologies are the most frequent endocrinopathies associated with anticancer immunotherapy.
- Hypothyroidism affects 3-22% and thyrotoxicosis 1-11% of patients undergoing immunotherapy.
- Risk increases with anti-PD-1 and combination therapies.
Purpose of the Study:
- To outline the incidence, pathophysiology, and management of thyroid dysfunction in patients receiving cancer immunotherapy.
- To establish screening protocols and therapeutic strategies for immunotherapy-induced thyroid disorders.
Main Methods:
- Systematic screening including clinical assessment and TSH assays before and during immunotherapy.
- Monitoring of thyroid function, symptomatic treatment for thyrotoxicosis.
- Levothyroxine replacement for symptomatic hypothyroidism or elevated TSH levels.
Main Results:
- The primary pathophysiology involves silent inflammatory thyroiditis, leading to transient thyrotoxicosis then hypothyroidism.
- Thyroid dysfunction onset typically does not necessitate immunotherapy interruption due to its transient and manageable nature.
Conclusions:
- Systematic screening and prompt management of thyroid dysfunction are crucial for patients on cancer immunotherapy.
- Collaborative efforts between oncologists and endocrinologists enhance patient care during immunotherapy treatment.
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