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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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The endocrine system is an extensive network of glands – organs or tissues in the body that create chemicals that control many bodily functions, that secrete hormones, which are chemical messengers that play essential roles in regulating various bodily functions. These hormones are secreted into the bloodstream and travel throughout the body. They require specific receptors to convey signals to cells possessing these corresponding receptors. This complex signaling mechanism ensures that...
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[Endocrine Dysfunction Associated with Immune Checkpoint Blockade].

Shintaro Iwama1

  • 1Dept. of Endocrinology and Diabetes, Nagoya University Hospital.

Gan to Kagaku Ryoho. Cancer & Chemotherapy
|May 9, 2020
PubMed
Summary

Immune checkpoint inhibitors can cause serious endocrine side effects. Anti-thyroid antibodies at baseline predict thyroid dysfunction risk from nivolumab therapy.

Area of Science:

  • Oncology
  • Immunology
  • Endocrinology

Background:

  • Immune checkpoint inhibitors (ICIs) are crucial in treating advanced cancers.
  • ICIs can trigger immune-related adverse events (irAEs) affecting multiple organs, including endocrine glands.
  • Endocrine irAEs like hypopituitarism and thyroid dysfunction pose life-threatening risks.

Purpose of the Study:

  • To highlight the clinical significance of endocrine irAEs.
  • To emphasize the need for understanding and managing these adverse events.
  • To identify predictive biomarkers for specific ICI-induced endocrine toxicities.

Main Methods:

  • Review of clinical features of various endocrine irAEs.
  • Analysis of patient data to identify risk factors for ICI-induced endocrine dysfunction.

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  • Investigation of baseline biomarkers for predicting thyroid dysfunction.

    • Main Results:

    • Endocrine irAEs encompass a range of conditions including hypopituitarism, adrenal insufficiency, thyroid dysfunction, hypoparathyroidism, and type 1 diabetes.
    • These irAEs can lead to severe complications such as adrenal crisis and thyroid storm.
    • The study identified anti-thyroid antibodies at baseline as a predictive biomarker for thyroid dysfunction in patients treated with the anti-PD-1 antibody, nivolumab.

    Conclusions:

    • Effective management of endocrine irAEs is critical for patient safety during ICI therapy.
    • Baseline anti-thyroid antibodies serve as a valuable biomarker for identifying patients at high risk of nivolumab-induced thyroid dysfunction.
    • Proactive monitoring and management strategies are essential for mitigating severe consequences of endocrine irAEs.