The Current Understanding of the Endocrine Effects From Immune Checkpoint Inhibitors and Recommendations for Management

JNCI Cancer Spectrum

Sharon, Elad¹  Byun, David J²  Min, Le³  Hansen, Aaron⁴  Girotra, Monica⁵  Farooki, Azeez⁵  Atkins, Michael B⁶  Callahan, Margaret K⁷  Antonia, Scott J⁸  Creelan, Ben C⁸  West, Pamela⁹  Gravell, Amy E⁹ 

[1]Cancer Therapy Evaluation Program, National Cancer Institute, Rockville, MD

[2]Department of Medicine

[3]Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA

[4]Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada

[5]Endocrine Division, Department of Medicine, Weill Cornell Medical College

[6]Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC

[7]Memorial Sloan-Kettering Cancer Center, New York, NY

[8]Moffitt Cancer Center, Tampa, FL

[9]The Emmes Corporation, Rockville, MD

关键词: endocrine system diseases;    diabetes mellitus, type 1;    cancer;    autoimmunity;    ligands;    thyroid diseases;    guidelines;    cytotoxic t-lymphocyte antigen 4;    toxic effect;    adverse event;    cell cycle checkpoint;    immune checkpoint inhibitors;    hypophysitis;    immune system;    antibodies, blocking;    patient care management;    addison's disease;    immunotherapy;    hyperglycemia;    pituitary gland;   

DOI  :  10.1093/jncics/pky021

学科分类：肿瘤学

来源: Oxford University Press

【 摘 要 】

Clinical trials in the past decade have established the antitumor effects of immune checkpoint inhibition as a revolutionary treatment for cancer. Namely, blocking antibodies to cytotoxic T-lymphocyte antigen 4 and programmed death 1 or its ligand have reached routine clinical use. Manipulation of the immune system is not without side effects, and autoimmune toxicities often known as immune-related adverse events (IRAEs) are observed. Endocrine IRAEs, such as hypophysitis, thyroid dysfunction, and insulin-dependent diabetes mellitus, can present with unique profiles that are not seen with the use of traditional chemotherapeutics. In this Review, we discuss the current hypotheses regarding the mechanism of these endocrinopathies and their clinical presentations. Further, we suggest guidelines and algorithms for patient management and future clinical trials to optimize the detection and treatment of immune checkpoint–related endocrinopathies.

【 授权许可】

CC BY-NC-ND