Endocrine dysfunction induced by immune checkpoint inhibitors

Area of Science:

• Oncology
• Endocrinology
• Immunology

Background:

• Immune checkpoint inhibitors (ICPis) are widely used for advanced cancers since 2011.
• ICPis modulate immune responses for antitumor effects but can cause unique adverse events.
• Monitoring for these side effects is essential for patient safety.

Purpose of the Study:

• To review endocrine dysfunctions associated with ICPis.
• To emphasize the importance of diagnosing and managing these adverse effects.
• To provide an overview of immune-related endocrine toxicities.

Main Methods:

• Literature review of endocrine dysfunctions induced by ICPis.
• Analysis of diagnostic challenges and management strategies.
• Synthesis of information on thyroid dysfunction, hypophysitis, type 1 diabetes, adrenal insufficiency, and hypoparathyroidism.

Main Results:

• ICPi-induced endocrine toxicities include thyroid dysfunction, hypophysitis, type 1 diabetes, primary adrenal insufficiency, and hypoparathyroidism.
• Diagnosis can be challenging due to nonspecific symptoms and biochemical evaluation difficulties.
• These adverse events can be life-threatening if not managed.

Conclusions:

• Effective replacement treatments are available for endocrine adverse events.
• An interdisciplinary approach is vital for managing these toxicities.
• Timely diagnosis and treatment positively impact patient survival and allow continued ICPi therapy.