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[Endocrine consequences of immune checkpoint inhibitors]

A S Chachati1, I Potorac1, P Petrossians1

  • 1Service d'Endocrinologie, CHU Liège, Belgique.

Revue Medicale De Liege
|December 14, 2019
PubMed

Insights

Immune checkpoint inhibitors, like those targeting CTLA-4, PD-1, and PD-L1, can cause immune-related side effects affecting endocrine glands. Early diagnosis and treatment are crucial for managing these side effects in cancer patients.

Area of Science:

  • Oncology
  • Immunology
  • Endocrinology

Background:

  • Immune checkpoint inhibitors (ICIs) targeting CTLA-4, PD-1, and PD-L1 have revolutionized cancer treatment.
  • ICIs restore anti-tumor T-cell activity by blocking immune tolerance mechanisms.
  • While effective, ICIs can disrupt the natural immune tolerance to auto-antigens, leading to immune-related adverse events (irAEs).

Purpose of the Study:

  • To outline monitoring and treatment strategies for endocrine immune side effects caused by ICIs.
  • To emphasize the importance of early detection and intervention for managing irAEs.
  • To provide clinicians with practical algorithms for addressing endocrine irAEs in cancer patients.

Main Methods:

  • Review of current literature on ICI-induced endocrine irAEs.
  • Development of clinical algorithms for monitoring and managing endocrine irAEs.
  • Analysis of common endocrine glands affected by ICIs.

Main Results:

  • Endocrine glands are frequently affected by ICI therapy, alongside cutaneous and digestive systems.
  • Specific monitoring protocols and treatment algorithms are proposed for endocrine irAEs.
  • Timely management of endocrine irAEs can mitigate negative impacts on cancer care.

Conclusions:

  • ICI therapy necessitates vigilant monitoring for endocrine irAEs.
  • Implementing structured monitoring and treatment algorithms is essential for optimal patient outcomes.
  • Proactive management of endocrine irAEs supports the successful continuation of oncologic care.
Keywords:
Endocrine autoimmune diseaseHypophysitisThyroiditisImmune checkpoints inhibitors

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