Journal
FRONTIERS IN ENDOCRINOLOGY
Volume 13, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fendo.2022.1010279
Keywords
immune checkpoint inhibitors; cancer treatment; CTLA-4; PD-1; PD-L1; immune-related adverse events; endocrine; thyroid
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Funding
- Romanian Ministry of Education and Research, CNCS - UEFISCDI within PNCDI III [PN-III-P4-ID-PCE-2020-2027]
- Ministry of Research, Innovation and Digitization in Romania [31PFE/30.12.2021]
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Immune checkpoint inhibitors are effective in cancer treatment, but can lead to immune-related adverse events, including thyroid dysfunction. Early prediction and detection of these events are crucial, as they can serve as prognostic markers and indicators of treatment response.
Immune checkpoint inhibitors, namely anti-CTLA-4, anti-PD-1 and anti-PD-L1 monoclonal antibodies, have emerged in the last decade as a novel form of cancer treatment, promoting increased survival in patients. As they tamper with the immune response in order to destroy malignant cells, a new type of adverse reactions has emerged, known as immune-related adverse events (irAEs), which frequently target the endocrine system, especially the thyroid and hypophysis. Thyroid irAEs include hyperthyroidism, thyrotoxicosis, hypothyroidism and a possibly life-threatening condition known as the thyroid storm. Early prediction of occurrence and detection of the thyroid irAEs should be a priority for the clinician, in order to avoid critical situations. Moreover, they are recently considered both a prognostic marker and a means of overseeing treatment response, since they indicate an efficient activation of the immune system. Therefore, a multidisciplinary approach including both oncologists and endocrinologists is recommended when immune checkpoint inhibitors are used in the clinic.
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