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Immune checkpoint inhibitor-related hypogonadism and infertility: a neglected issue in immuno-oncology

Berna C Özdemir1,2

  • 1Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland berna.oezdemir@insel.ch.

Journal for Immunotherapy of Cancer
|February 16, 2021
PubMed

Insights

Immune checkpoint inhibitors (ICIs) may impact gonadal function, increasing infertility risks. Further research is needed to understand these effects, especially in young patients receiving adjuvant therapy.

Area of Science:

  • Oncology
  • Endocrinology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) are increasingly used for cancer treatment.
  • Immune-related adverse events (irAEs) affect multiple organ systems.
  • The impact of ICIs on gonadal function remains understudied.

Purpose of the Study:

  • To investigate the effects of ICIs on gonadal function.
  • To assess the risk of hypogonadism and infertility associated with ICI therapy.
  • To highlight the need for systematic evaluation of gonadal function in patients receiving ICIs.

Main Methods:

  • Systematic review of existing literature.
  • Analysis of reported cases of hypogonadism (primary and secondary) in patients on ICIs.
  • Evaluation of potential mechanisms, including orchitis and hypophysitis.

Main Results:

  • Limited evidence suggests ICIs can cause primary hypogonadism (orchitis) and secondary hypogonadism (hypophysitis).
  • These conditions pose a risk for infertility in patients treated with ICIs.
  • The influence of sex hormones on ICI efficacy and toxicity is a potential concern.

Conclusions:

  • ICI therapy carries a potential risk of gonadal dysfunction and infertility.
  • Systematic monitoring of gonadal function is crucial for patients undergoing ICI treatment.
  • Further research is warranted, particularly in young populations and those receiving adjuvant therapy.
Keywords:
immunotherapy

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