Thyroid disorders induced by checkpoint inhibitors

Reviews in Endocrine & Metabolic Disorders
Silvia Martina FerrariAlessandro Antonelli

Abstract

Immune checkpoint inhibitors are drugs that inhibit the "checkpoint molecules". Different types of cancer immune checkpoint inhibitors have been approved recently: CTLA-4 monoclonal antibodies (as ipilimumab); anti-PD-1 monoclonal antibodies (as pembrolizumab and nivolumab); and anti-PD-L1 monoclonal antibodies (as atezolizumab, avelumab, and durmalumab). The increased immune response induced by these agents leads to immune-related adverse events (irAEs), that can vary from mild to fatal, according to the organ system and severity. Immune-related endocrine toxicities are thyroid dysfunctions, hypophysitis, adrenal insufficiency, and type 1 diabetes mellitus, and are usually irreversible in 50%. In particular, hypophysitis is the most frequent anti-CTLA-4-antibodies-related irAE, while thyroid abnormalities (as hypothyroidism, thyrotoxicosis, painless thyroiditis, or even "thyroid storm") are more frequently associated with anti-PD-1-antibodies. The combination of anti-CTLA-4-antibodies, with anti-PD-1-antibodies, is associated with about 30% of irAEs. Clinical signs and symptoms vary according to the influenced target organ. Endocrinopathies can often be managed by the treating oncologist. However in more severe cases (i.e. in ...Continue Reading

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Citations

Jan 19, 2019·Reviews in Endocrine & Metabolic Disorders·Christian A Koch, Alessandro Antonelli
May 30, 2019·International Journal of Molecular Sciences·Silvia Martina FerrariAlessandro Antonelli
Dec 4, 2019·Current Opinion in Endocrinology, Diabetes, and Obesity·Paul B Kaplowitz, Priya Vaidyanathan
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Aug 7, 2021·Frontiers in Endocrinology·Alessandro AntonelliPaolo Miccoli
Aug 27, 2021·Clinical Practice and Cases in Emergency Medicine·Robert ClontzBrent A Becker
Sep 1, 2021·Reviews in Endocrine & Metabolic Disorders·Zhongqin GongGeorge G Chen
Sep 19, 2021·International Journal of Cancer. Journal International Du Cancer·Lei XuXiaoping Chen

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