期刊
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
卷 105, 期 12, 页码 -出版社
ENDOCRINE SOC
DOI: 10.1210/clinem/dgaa553
关键词
immune checkpoint inhibitors; immune-related adverse events; autoimmune polyendocrine syndrome
资金
- National Natural Science Foundation of China [81700689]
Context: Immune checkpoint inhibitors (ICPis) targeting cytotoxic T-Iymphocyte antigen 4 (CTLA-4), programmed cell death protein 1 (PD-1), and its ligand (PD-L1) are now approved to treat a variety of cancers. However, ICPis therapy is associated with a risk of immune-related adverse events (irAEs). Autoimmune polyendocrine syndrome type 2 (APS-2) is a rare endocrine irAE. Evidence Acquisition: Several databases (PubMed, Web of Science, Cochrane Central Registry of ControlledTrials, ClinicalTrials.gov, and Scopus) were searched up to February 18, 2020, for case reports on endocrine irAEs and ICPis. The reported side effects and adverse events of the ICPis therapy in the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) adverse events pharmacovigilance registries are also included. Evidence Synthesis: Here, we provide an overview of all published and reported cases (n = 30) of ICPis-induced APS-2. We summarize the clinical characteristics, autoantibodies, human leukocyte antigen (HLA) genotypes, and therapies and propose an APS-2 screening strategy. Conclusions: Given the life-threatening risks of endocrine dysfunction if it is not promptly recognized (such as diabetic ketoacidosis and acute adrenal crisis), physicians (especially endocrinologists and oncologists) should be familiar with APS-2. After diagnosis of an autoimmune disease induced by ICPis (especially PD-1 inhibitors), patients with a high-risk HLA allele (HLA-DR4) require close monitoring for the development of APS-2.
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