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The Current Understanding of the Endocrine Effects From Immune Checkpoint
Inhibitors and Recommendations for Management
#MMPMID30057972
Girotra M
; Hansen A
; Farooki A
; Byun DJ
; Min L
; Creelan BC
; Callahan MK
; Atkins MB
; Sharon E
; Antonia SJ
; West P
; Gravell AE
JNCI Cancer Spectr
2018[Jul]; 2
(3
): pky021
PMID30057972
show ga
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.