Endocrinopathies by Oncological Immunotherapy

Article Sidebar

PDF (Spanish)

Main Article Content

Ester Gabriela Scheinfeld
Servicio de Endocrinología, Metabolismo y Medicina Nuclear. Hospital Italiano de Buenos Aires. Argentina
Soledad Lovazzano
Servicio de Endocrinología, Metabolismo y Medicina Nuclear. Hospital Italiano de Buenos Aires. Argentina
María Fernanda Ramajo
Servicio de Endocrinología, Metabolismo y Medicina Nuclear. Hospital Italiano de Buenos Aires. Argentina

Abstract

The relationship between immunity and cancer is complex. Tumor cells develop evasion mechanisms to the immune system responses. This ability allows their survival and progression. Immunotherapy has transformed cancer treatment by improving the immune response against tumor cells. This is achieved by blocking immune checkpoints with monoclonal antibodies against cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and programmed cell death protein 1 and its ligand (PD-1 / PD-L1). Although the immune checkpoint inhibitors (ICIs) are well tolerated drugs, they have a profile of adverse effects known as immune-related adverse events (irAES). These involve diverse systems, including the endocrine glands. The most frequent endocrine immune-related adverse events are thyroid and pituitary dysfunction, autoimmune diabetes mellitus and primary adrenal insufficiency. The increasing knowledge of these irAES has led to effective treatment strategies with the corresponding hormonal replacement. The objective of this review is to recognize the incidence of these new endocrinopathies, the physiopathology, their clinical evaluation, and therapeutic management.

Downloads

##plugins.themes.bootstrap3.displayStats.noStats##
Published: 2020-09-30
DOI: https://doi.org/10.51987/Rev.Hosp.Ital.B.Aires.v40i3.443
Keywords:
immunotherapy, immune checkpoint inhibitors, immune-related adverse events(irAEs), endocrinopathies, adrenal insufficiency, hypophysitis, autoimmune diabetes, hypothyroidism, hyperthyroidism, thyroiditis

Article Details

Issue

Vol. 40 No. 3 (2020): Revista del Hospital Italiano de Buenos Aires

Section

Review
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

How to Cite

1.
Scheinfeld EG, Lovazzano S, Ramajo MF. Endocrinopathies by Oncological Immunotherapy. Rev Hosp Ital B.Aires [Internet]. 2020 Sep. 30 [cited 2026 Jul. 31];40(3):95-104. Available from: https://ojs.hospitalitaliano.org.ar/index.php/revistahi/article/view/443

References

Barquín-García A, Molina-Cerrillo J, Garrido P, et al. New oncologic emergencies: What is there to know about immunotherapy and its potential side effects?. Eur J Intern Med. 2019; 66:1-8.

Chang LS, Barroso-Sousa R, Tolaney S, et al. Endocrine Toxicity of Cancer Immunotherapy Targeting Immune Checkpoints Endocrinopathy. Endocrine Reviews. 2019; 40:17-65.

Vargas-Rojas M, Jiménez-Álvarez L, Ramírez G y cols. PD-1 y sus ligandos como reguladores de la respuesta inmune. Rev Inst Nal Enf Resp Mex. 2008; 21:272-9.

Nogueira E, Newsom-Davis T, Morganstein D. Immunotherapy-induce endocrinopathies: assessment, management and monitoring. Ther Adv Endocrinol Metab. 2019; 10:1-10.

Castinetti F, Albarel F, Archambeaud F, et al. French Endocrine Society Guidance on endocrine side effects of immunotherapy. Endocr Relat Cancer. 2019 ; 26:1-18.

Barroso-Sousa R, Ott P, Hodi F, et al. Endocrine Dysfunction Induced by Immune Checkpoint Inhibitors: Practical Recommendations for Diagnosis and Clinical Management. Cancer. 2018; 124:1111-21.

Jannin A, Penel N, Ladsous M, et al. Tyrosine kinase inhibitors and immune checkpoint inhibitors-induced thyroid disorders. Crit Rev Oncol Hematol. 2019; 141:23-35.

Del Rivero J, Cordes L, Klubo-Gwiezdzinska J, et al. Endocrine-Related Adverse Events Related to Inmune Checkpoint Inhibitors: Proposed Algorithms for Management. The Oncologist. 2019; 24:1-11.

Lyer PC, Cabanillas ME, Waguespack SG, et al. Immune-Related Thyroiditis with Immune Checkpoint Inhibitors. Thyroid. 2018; 28:1243-51.

Malikova H, Holesta M, Fialova A, et al. Hypophysitis and other autoimmune complications related to immune checkpoints inhibitors treatment: Spectrum of imaging appearances. Neuro Endocrinol Lett. 2018; 39:196-204.

Chodakiewitz Y, Sanford Brown JL, Boxerman JM, et al. Ipilimumab treatment associated pituitary hypophysitis: Clinical presentation and imaging diagnosis. Clin Neurol Neurosurg. 2014; 125:125-30.

de Filette JMK, Pen JJ, Decoster L, et al. Immune checkpoint inhibitors and type 1 diabetes mellitus: a case report and systematic review. Eur J Endocrinol. 2019; 181:363-74.

Valecha G, Pant M, Ibrahim U, et al. Immunotherapy-induced autoimmune hypophysitis. J Oncol Pharm Pract. 2019; 25:217-20.

Hiroshi A, Shintaro I, Hidefumi I, et al. Management of immune-related adverse events in endocrine organs induced by immune checkpoint inhibitors: clinical guidelines of the Japan Endocrine Society. Endocr J. 2019; 66:581-86.

Grouthier V, Lebrun-Vignes B, Moey M, et al. Immune Checkpoint Inhibitors Associated Primary Adrenal Insufficiency: WHO VigiBase Report Analysis. The oncologist. 2020;10.1634/theoncologist.2019-0555.

Ariyasu R, Atsushi H, Takahiro Y, et al. Adrenal Insufficiency Related to Anti-Programmed Death-1 Therapy. Anticancer Res. 2017; 37:4229-32.

Tan MH, Iyengar R, Mizokami-Stout K, et al. Spectrum of immune checkpoint inhibitors-induced endocrinopathies in cancer patients: a scoping review of case reports. Clin Diabetes Endocrinol. 2019; 5:1-21.