Endocrine-Related Adverse Conditions in Pediatric Patients Treated with Immune Checkpoint Inhibition for Malignancies
1The Jesse Z. and Lea Shafer Institute of Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Background:
In recent years, remarkable advances in cancer immunotherapy have been introduced in the field of oncology. Since the discovery of immune checkpoint inhibitors (ICIs), these groups of medications have become a crucial treatment for several types of adult cancer.
Summary:
To date, pediatric experience with this group of medications is limited. Nevertheless, as clinicians, we have to be aware of the possible immune-related adverse events including immune-related endocrinopathies (thyroid dysfunction, diabetes mellitus, adrenal insufficiency, and pituitary insufficiency) that have been reported regarding these medications. These adverse events probably result from uncontrolled activation of the immune system.
Key Message:
Early diagnosis, monitoring, and treatment of immune-related endocrinopathies associated with ICIs treatment are also essential for the best supportive care and administration of ICIs in pediatric patients. This review presents the current data on the immune-related endocrinopathies associated with the ICIs treatment, with suggestions for management.
Insights
Pediatric cancer patients may experience immune-related endocrinopathies from immune checkpoint inhibitors (ICIs). Early detection and management of these adverse events are crucial for effective treatment and supportive care.
Area of Science:
- Oncology
- Immunology
- Endocrinology
Background:
- Cancer immunotherapy has advanced significantly, with immune checkpoint inhibitors (ICIs) becoming vital in adult cancer treatment.
- Pediatric experience with ICIs is limited but growing.
- Immune-related adverse events (irAEs) are a known complication of ICIs.
Purpose of the Study:
- To review current data on immune-related endocrinopathies in pediatric patients receiving ICIs.
- To provide suggestions for the management of these adverse events.
Main Methods:
- Literature review of studies on ICIs and endocrinopathies in pediatric populations.
- Analysis of reported cases and clinical guidelines.
Main Results:
- Immune-related endocrinopathies, including thyroid dysfunction, diabetes mellitus, adrenal insufficiency, and pituitary insufficiency, have been reported in pediatric patients on ICIs.
- These events are likely due to the overactivation of the immune system.
Conclusions:
- Clinicians must be aware of potential immune-related endocrinopathies in pediatric patients treated with ICIs.
- Early diagnosis, monitoring, and prompt treatment are essential for optimal supportive care and continued ICI therapy in children.
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