Immunotherapy-induced endocrinopathies: assessment, management and monitoring. (December 2019)

• Record Type: Journal Article
• Authors: Nogueira, Edson; Newsom-Davis, Tom; Morganstein, Daniel L.
• Is Part Of: Therapeutic advances in endocrinology and metabolism. Volume 10(2019)
• Publication Date: 2019-12
• Subjects: cancer -- diabetes -- endocrinopathy -- glucocorticoids -- hypophysitis -- immunotherapy -- thyroiditis; Endocrine glands -- Diseases -- Treatment -- Periodicals; Metabolism -- Disorders -- Treatment -- Periodicals; Endocrine System Diseases -- therapy -- Periodicals; Metabolic Diseases -- therapy -- Periodicals; 616.4005
• DOI: 10.1177/2042018819896182
• Languages: English
• ISSNs: 2042-0188

Abstract

Immunotherapy with checkpoint inhibitors has transformed the treatment of cancer, but frequently results in immune-mediated adverse events affecting multiple organs, amongst which endocrine adverse events are frequent. The patterns of endocrine adverse events differ between inhibitors of the CTLA-4 and PD-1/PD-L1 pathways, but most frequently involve the thyroid and pituitary with insulin deficient diabetes also emerging as an important adverse event. These frequently result in long-lasting hormone deficiency requiring replacement. This review explores the mechanism of action of checkpoint inhibitors and details the expected endocrine adverse events and typical presentations. The effect of high-dose glucocorticoids therapy to treat nonendocrine adverse events is also discussed.