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Updated: Nov 23, 2025

Analysis of Human T Cell Activity in an Allogeneic Co-Culture Setting of Pre-Treated Tumor Cells
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Immune checkpoint inhibitor-associated hypercalcaemia.

Hassan Izzedine1, Thibaud Chazal2, Rimda Wanchoo3

  • 1Department of Nephrology, Peupliers Private Hospital, Ramsay Générale de Santé, Paris, France.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|December 29, 2020
PubMed
Summary
This summary is machine-generated.

Immune checkpoint inhibitors (CPIs) can cause hypercalcaemia, a rare immune-related adverse event (irAE). This review explores CPI-induced hypercalcaemia causes, diagnosis, and management in cancer patients.

Keywords:
PTHrpanti-CTLA4 antibodieshypercalcaemiaprogrammed cell death-1programmed cell death-ligand 1

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Area of Science:

  • Oncology
  • Immunology
  • Endocrinology

Background:

  • Immune checkpoint inhibitors (CPIs) are vital in advanced cancer treatment, activating the immune system against tumors.
  • CPIs can induce immune-related adverse events (irAEs), including endocrinopathies.
  • Hypercalcaemia is an underreported irAE associated with CPI therapy.

Purpose of the Study:

  • To review the incidence, diagnosis, and management of immune-related hypercalcaemia in cancer patients treated with CPIs.
  • To elucidate the mechanisms underlying CPI-induced hypercalcaemia.

Main Methods:

  • Literature review focusing on immune checkpoint inhibitors and hypercalcaemia.
  • Analysis of reported cases and proposed mechanisms of CPI-related hypercalcaemia.

Main Results:

  • Four distinct causes of CPI-associated hypercalcaemia were identified: endocrine disease, sarcoid-like granuloma, humoral hypercalcaemia of malignancy (via parathyroid hormone-related protein), and hyperprogressive disease.
  • Mechanisms linking CPIs to hypercalcaemia are not fully established but involve immune system reactivation.

Conclusions:

  • Hypercalcaemia is a potentially life-threatening irAE associated with CPIs that requires prompt recognition and management.
  • Understanding the underlying aetiologies is crucial for effective treatment of CPI-induced hypercalcaemia in oncological patients.