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Endocrinopathies Associated With Immune Checkpoint Inhibitor Use.

Anupam Kotwal1, Randol Kennedy2, Nupur Kikani3

  • 1Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska; Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|March 30, 2024
PubMed
Summary
This summary is machine-generated.

Immune checkpoint inhibitor (ICI)-associated endocrinopathies, like thyroiditis, often cause permanent hormone deficiency. While ICI-thyroiditis may improve cancer survival, other endocrinopathies do not significantly impact outcomes.

Keywords:
adrenal insufficiencycancer immunotherapydiabetes mellitushypophysitishypothyroidismthyroiditis

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Area of Science:

  • Oncology
  • Endocrinology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) are crucial cancer therapies.
  • Immune-related adverse events (irAEs) can affect any organ system.
  • Endocrine glands are frequent targets of ICI-induced irAEs.

Purpose of the Study:

  • To outline a clinical approach for ICI-associated endocrinopathies.
  • To examine the link between these conditions and cancer outcomes.
  • To identify factors differentiating them from other irAEs and propose health system innovations.

Main Methods:

  • Literature search on ICIs and endocrinopathies.
  • Incorporation of expert opinions from authors.

Main Results:

  • Endocrinopathies, particularly thyroiditis, are common ICI-related irAEs.
  • ICI-associated endocrinopathies are distinct from classic autoimmune endocrine diseases.
  • Management requires long-term hormone replacement, with ICI discontinuation rarely needed.
  • ICI-thyroiditis is linked to improved cancer survival; other endocrinopathies show no significant outcome association.

Conclusions:

  • This review offers guidance for clinicians managing ICI-associated endocrinopathies.
  • Oncoendocrinology teams can enhance patient care.
  • The findings complement existing scientific frameworks.