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Review
. 2023 Aug 7;12(15):5161.
doi: 10.3390/jcm12155161.

Endocrine Side Effects in Patients Treated with Immune Checkpoint Inhibitors: A Narrative Review

Affiliations
Review

Endocrine Side Effects in Patients Treated with Immune Checkpoint Inhibitors: A Narrative Review

Nicia I Profili et al. J Clin Med. .

Abstract

Checkpoint inhibitors are monoclonal antibodies that elicit an anti-tumor response by stimulating immune system. Their use has improved the treatment of different types of cancer such as melanoma, breast carcinoma, lung, stomach, colon, liver, renal cell carcinoma, and Hodgkin's lymphoma, but several adverse events have been reported. Although the etiology of these effects is not completely understood, an uncontrolled activation of the immune system has been postulated. Indeed, some studies showed a cross reactivity of T cells, which acted against tumor antigens as well as antigens in the tissues of patients who developed immune-related adverse events. Despite the known possibility of developing immune-related adverse events, early diagnosis, monitoring during therapy, and treatment are fundamental for the best supportive care and administration of immune checkpoint inhibitors. The aim of this review is to guide the clinician in early diagnosis, management, and treatment of the endocrinological adverse effects in the major endocrine glands (thyroid, pituitary, adrenal, endocrine pancreas, and parathyroid).

Keywords: CTLA-4; PD-1; PD-L1; adrenal; endocrine side effects; immune checkpoint inhibitors; pituitary; thyroid.

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Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Chen R.Y., Zhu Y., Shen Y.Y., Xu Q.Y., Tang H.Y., Cui N.X., Jiang L., Dai X.M., Chen W.Q., Lin Q., et al. The role of PD-1 signaling in health and immune-related diseases. Front. Immunol. 2023;14:1163633. doi: 10.3389/fimmu.2023.1163633. - DOI - PMC - PubMed
    1. Zhang Y., Zheng J. Functions of Immune Checkpoint Molecules Beyond Immune Evasion. Adv. Exp. Med. Biol. 2020;1248:201–226. doi: 10.1007/978-981-15-3266-5_9. - DOI - PubMed
    1. Qin W., Hu L., Zhang X., Jiang S., Li J., Zhang Z., Wang X. The Diverse Function of PD-1/PD-L Pathway Beyond Cancer. Front. Immunol. 2019;10:2298. doi: 10.3389/fimmu.2019.02298. - DOI - PMC - PubMed
    1. Kennedy A., Waters E., Rowshanravan B., Hinze C., Williams C., Janman D., Fox T.A., Booth C., Pesenacker A.M., Halliday N., et al. Differences in CD80 and CD86 transendocytosis reveal CD86 as a key target for CTLA-4 immune regulation. Nat. Immunol. 2022;23:1365–1378. doi: 10.1038/s41590-022-01289-w. - DOI - PMC - PubMed
    1. Seidel J.A., Otsuka A., Kabashima K. Anti-PD-1 and Anti-CTLA-4 Therapies in Cancer: Mechanisms of Action, Efficacy, and Limitations. Front. Oncol. 2018;8:86. doi: 10.3389/fonc.2018.00086. - DOI - PMC - PubMed