Endocrine Side Effects in Patients Treated with Immune Checkpoint Inhibitors: A Narrative Review

Area of Science:

• Oncology
• Immunology
• Endocrinology

Background:

• Immune checkpoint inhibitors (ICIs) are monoclonal antibodies enhancing anti-tumor immune responses.
• ICIs have improved outcomes in various cancers but are associated with immune-related adverse events (irAEs).
• irAEs are thought to stem from uncontrolled immune activation and potential T-cell cross-reactivity.

Purpose of the Study:

• To provide clinicians with guidance on the early diagnosis and management of ICI-induced endocrinopathies.
• To cover adverse effects affecting key endocrine glands: thyroid, pituitary, adrenal, pancreas, and parathyroid.
• To emphasize the importance of monitoring and timely treatment for optimal patient support during ICI therapy.

Main Methods:

• Review of current literature on immune checkpoint inhibitors and their endocrinological adverse events.
• Synthesis of information regarding the mechanisms, clinical presentation, and management strategies for irAEs.
• Focus on endocrine glands including thyroid, pituitary, adrenal, pancreas, and parathyroid.

Main Results:

• Immune checkpoint inhibitors can lead to significant adverse events affecting multiple endocrine glands.
• Early identification and management are crucial for mitigating the impact of these endocrinopathies.
• Understanding potential immune system overactivation is key to managing these side effects.

Conclusions:

• Endocrinological adverse events are a significant concern with immune checkpoint inhibitor therapy.
• Clinicians require clear guidelines for the prompt diagnosis, monitoring, and treatment of these effects.
• Effective management of irAEs ensures patient safety and supports the continued use of these vital cancer therapies.