Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb;88(2):327-332.
doi: 10.1111/cen.13483. Epub 2017 Oct 9.

Endocrinopathies with use of cancer immunotherapies

Natalie M Villa  1 , Abtin Farahmand  2 , Lin Du  3 , Michael W Yeh  4 , Stephanie Smooke-Praw  5 , Antoni Ribas  6 , Bartosz Chmielowski  6 , Grace Cherry  6 , Angela M Leung  5   7
Affiliations

Endocrinopathies with use of cancer immunotherapies

Natalie M Villa et al. Clin Endocrinol (Oxf). 2018 Feb.

Abstract

Background: Immunomodulatory therapies, including CTLA-4 and PD-1 inhibitors, provide a directed attack against cancer cells by preventing T cell deactivation. However, these drugs also prevent the downregulation of auto-reactive T cells, resulting in immune-related adverse events (IRAEs). Reports show a varied incidence of endocrine IRAEs, ranging from 0% to 63%.

Objective: To describe the frequency and clinical characteristics of endocrine IRAEs in patients taking cancer immunomodulatory therapies.

Design: Retrospective cohort study.

Patients: A total of 388 patients aged ≥18 years who were prescribed ipilimumab, nivolumab and/or pembrolizumab between 2009 and 2016 at our institution.

Measurements: Biochemical criteria were used to define endocrine IRAEs, including thyroid, pituitary, pancreas and adrenal dysfunction, following use of immunomodulatory therapies.

Results: Fifty endocrine IRAEs occurred in our cohort, corresponding to a rate of 12.9%. The most common endocrine IRAEs were thyroid dysfunction (11.1%), with a lower incidence of pituitary dysfunction (1.8% of patients).

Conclusions: Over 12% of patients receiving ipilimumab, nivolumab and/or pembrolizumab in our study sample developed an endocrine IRAE. Patients who undergo treatment with immunomodulatory therapies should be monitored for the development of endocrine IRAEs.

Keywords: hyperthyroidism; hypopituitarism; thyroiditis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Incidence Rates of Endocrine IRAEs Following Immunomodulatory Therapy Values are expressed as percentage of the total patient population (n=388), and as percentage of the total number of patients experiencing events (n=50).
See this image and copyright information in PMC

References

    1. Corsello SM, Barnabei A, Marchetti P, De Vecchis L, Salvatori R, Torino F. J Clin Endocrinol Metab. 4. Vol. 98. Endocrine Society Chevy Chase; MD: 2013. Apr 7, Endocrine side effects induced by immune checkpoint inhibitors; pp. 1361–75. - PubMed
    1. Daud A. Current and Emerging Perspectives on Immunotherapy for Melanoma. Semin Oncol. 2015 Dec;42( Suppl 3):S3–11. - PubMed
    1. Ribas A, Puzanov I, Dummer R, Schadendorf D, Hamid O, Robert C, et al. Lancet Oncol. 8. Vol. 16. Elsevier; 2015. Aug, Pembrolizumab versus investigator-choice chemotherapy for ipilimumab-refractory melanoma (KEYNOTE-002): a randomised, controlled, phase 2 trial; pp. 908–18. - PMC - PubMed
    1. Robert C, Schachter J, Long GV, Arance A, Grob JJ, Mortier L, et al. N Engl J Med. 26. Vol. 372. Massachusetts Medical Society; 2015. Jun 25, Pembrolizumab versus Ipilimumab in Advanced Melanoma; pp. 2521–32. - PubMed
    1. Wolchok JD, Kluger H, Callahan MK, Postow MA, Rizvi NA, Lesokhin AM, et al. Nivolumab plus ipilimumab in advanced melanoma. N Engl J Med. 2013 Jul 11;369(2):122–33. - PMC - PubMed

Publication types

MeSH terms